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Microscopic type-1 tympanoplasty (T1T) is a classical method for the treatment of chronic otitis media. However, it has its limitations. The development of otoendoscopy provided a new method for T1T.To investigate the difference between endoscopic T1T and microscopic T1T.Seventy-four patients who underwent T1T were evaluated retrospectively. About 52 cases underwent endoscopic T1T, and 22 cases accepted microscopic T1T. Parameters including operative duration, incision size, graft site, duration of postoperative hospitalization, visual analog scale (VAS) score, complications, hearing improvement, and expenses were compared.Operative duration of endoscopic T1T (47.0 ± 8.2 min) was shorter than microscopic T1T (58.0 ± 9.3 min) (Endoscopic T1T is a minimally invasive surgery with similar graft success rate, comparable hearing improvement, fast recovery, low cost, and high patient satisfaction compared to microscopic T1T.

It is important to achieve precise surface charge manipulation of non-spherical drug microcrystals using facile and time-efficient methods for local drug delivery. In this study, silk-coated dexamethasone (DEX) non-spherical microcrystals were synthesized by precipitation technique followed by alternate deposition of poly(allylamine hydrochloride) (PAH) (or PAH-coated Fe3O4) and silk fibroin (SF) via layer-by-layer assembly. EDC and glutaraldehyde were employed to manipulate positive or negative charge of particles by simple chemical cross-linking reactions, respectively. In vivo assessment was carried out by intratympanic (IT) injection of DEX non-spherical microcrystals in guinea pigs. In vivo pharmacokinetic results demonstrate that negatively charged DEX microcrystals appeared to improve outcomes of inner ear delivery in comparison to positively-charged counterparts. This is partly because of the adhesive features of the SF. The present study may provide new ideas to construct surface charge-tunable drug delivery vehicles that are capable of crossing biological barriers, especially for inner ear delivery due to the simple and practical strategy.

OBJECTIVE: Analysis of normal reference value of smooth pursuit test for normal young people. METHOD: Thirty normal young volunteers were tested by Synapsys videonystagmography. The maximum horizontal tracking angle was 30 °, the vertical maximum tracking angle was 20°, and the frequency was 0.30 Hz, 0.45 Hz and 0.60 Hz, respectively, and the gain under different conditions is used as the observation index. RESULT: When the frequency is 0.3 Hz, 0.45 Hz, 0.60 Hz, the left and right horizontal gain is 0.92±0.07/0.93±0.07, 0.87±0.08/0.88±0.11, 0.79±0.11/0.78±0.13, respectively, and the asymmetry of left/right gain is 0.021±0.017, 0.031±0.026, 0.037±0.040; the up and down vertical gain is 0.82±0.16/0.80±0.16, 0.78±0.17/0.72±0.15, 0.68±0.20/0.61±0.15, and the asymmetry of the upper/lower gain is 0.046±0.045, 0.069±0.058, 0.109±0.076. Comparing and analyzing the paired left and right gain values of the three frequencies by paired t test, the differences were not statistically significant (P>0.05). Paired t -test of gain value for different frequency of up and down stationary tracking, the difference was not statistically significant at 0.30 Hz(P>0.05), but the gain at 0.45 Hz and 0.60 Hz has significant difference(P < 0.05). Comparing the gains of different frequencies in the same direction, the differences in analysis of variance were statistically significant(P < 0.05). CONCLUSION: The gain value of smooth pursuit test for normal young people can be affected by tracking frequency and direction. At the same frequency, the left/right tracking of 3 frequencies and the up/down tracking gain values of 0.30 Hz are symmetrical, but at 0.45 Hz and 0.6 Hz, the up tracking gain is greater than the down tracking gain, and the gain value in the same direction gradually decreases with the increase of frequency, is the clinical smooth pursuit test is mainly based on 0.30 Hz.

To investigate the characteristics and clinical utility of vestibular autorotation test (VAT) in patients with vestibular migraine.This study included two groups, an experimental group (441 patients) and a control group (65 healthy subjects). Both groups undertook VAT; the parameters evaluated were horizontal gain/phase, vertical gain/phase and asymmetry. The differences in VAT results between the two groups were investigated.There were no statistical differences between the VAT data of the control group when compared to the reference value from the manufacturer (p .05). There were statistically significant differences in VAT results between the experimental and control group, namely elevated horizontal gain at frequency 2, 3, 4 and 5 Hz, horizontal phase delay at frequency 2, 4, 5 and 6 Hz, elevated vertical gain at frequency 2 6Hz and vertical phase delay at frequency 4 6Hz.The results of this study using VAT in VM patients demonstrate elevated horizontal gain, vertical gain and delay in horizontal phase, vertical phase. We suggest the application of VAT as a diagnostic tool which may provide objective evidence that can contribute to the diagnosis of VM and also in differential diagnosis.

The local drug delivery systems play an important role in treating sudden sensorineural hearing loss. In this work, we synthesized dexamethasone microcrystals (DEX MCs) using precipitation technique followed by silk coating via layer-by-layer assembly. Compared to raw DEX, the physicochemical properties including shape, crystal form, dispersity, dissolution or sustained release, of DEX MCs or poly-l-lysine/silk fibroin (PLL/SF) multilayers-coated DEX MCs (DEX-(PLL/SF)3) were investigated. More importantly, after a single intratympanic administration in guinea pigs, DEX-(PLL/SF)3 was uniformly distributed on the round window membrane (RWM) in comparison with raw DEX and DEX MCs. And increased concentration of DEX treatment resulted in higher perilymph DEX levels. No significant morphological change and inflammatory responses on the cochlear tissue were observed. Thus, the DEX-(PLL/SF)3 formulation could be a novel local drug delivery strategy to realize safe, efficient and sustainable DEX delivery into inner ear across RWM.

To discuss the characteristics of subjective visual gravity (subjective visual vertical/horizontal, SVV/SVH) and assess its clinical application for peripheral unilateral vestibular compensation.69 cases of acute peripheral unilateral vestibular dysfunction patients (case group) accepted SVV/SVH, spontaneous nystagmus (SN), caloric test (CT) and other vestibular function tests. 49 healthy people (control group) accepted SVV/SVH only. SVV/SVH, SN and unilateral weakness (UW) were selected as for the observation indicators. The correlations between SVV/SVH, SN, UW and courses were investigated respectively, as well as the characteristic of SVV/SVH, SN in period of vestibular compensation.Among case group SVV, SVH positive in 42 patients(60.9%) and 44 patients(63.8%), the absolute values of the skew angle were in the range between 2.1°-20.0°, 2.1°-22.2°. Skew angles of SVV/SVH in control were in the range between -1.5°-2.0° and -2.0°-1.6°, and had no statistical significance with case group(t=5.336 and 5.864, P0.05). SN-positive 28 cases (40.6%), the range of intensities at 2.4°-17.1°; UW-positive 50 cases (72.5%). In case group, positive correlation between SVV and SVH(r=0.948, P=0.00), negatively correlated between SVV/SVH and SN respectively(r values were -0.720, -0.733, P values were 0.00), no correlation between the skew angle of SVV/SVH, strength of SN and UW value(r values were 0.191, 0.189, and 0.179, P0.05), there was no correlation between the absolute value of SVV, SVH, SN, UW with the duration (rs values were -0.075, -0.065, -0.212, and 0.126, P0.05).Subjective visual gravity can be used not only to assess the range of unilateral peripheral vestibular dysfunction, but also help assess the static compensatory of otolithic, guidance and assessment of vestibular rehabilitation.

Using simultaneous multi-gene mutation screening to investigate the new method molecular epidemiological basis of 225 patients with nonsyndromic hearing loss in Tianjin, and verifying the for simultaneous multi-gene mutation screening.Two hundred and twenty-five patients with severe non-syndromic deafness from Tianjin CDPF and Association of the Deaf were included in the study. The single nucleotide polymorphisms scan, (SNPscan) technique was used for screening the 115 spots mutations in three common deafness-related genes (GJB2, SLC26A4, mtDNA 12S rRNA) of patients with nonsyndromic hearing loss in Tianjin. We verified the results by Sanger sequencing.Among the 225 patients, there were 111 cases of deafness caused by mutation (49.3%). Using this method, up to 50% of the patients in our study were identified to have hereditary HL caused by mutations in the three genes. 56 patients with the GJB2 mutations were detected (24.9%), including 30 cases of homozygous mutations (13.3%), 26 patients (11.6%) of compound heterozygous mutations, and 21 cases (9.33%) of single heterozygous mutations. 50 patients with the SLC26A4 mutations were detected (22.2%), including 22 cases of homozygous mutations(9.8%), 28 patients (12.4%) of compound heterozygous mutations, and 22 cases (9.8%) of single heterozygous mutations. mtDNA 12S rRNA A1555G mutation was detected in 5 patients (2.2%). mtDNA 12S rRNA 1494CT mutation was not detected. We verified the results by Sanger sequencing. The accuracy of the sequencing results was 100%. The SNPscan cost eight hours and 160 yuan (each sample).Applying SNPscan technology can be accurate, rapid and cost-effective diagnostic screening in patients with hearing loss for etiology investigation. It is expected to become an effective means of large-scale genetic testing for hereditary deafness.

To explore the clinical values of Sensory Organization Test (SOT) of dynamic posturography in the diagnosis of peripheral vertigo.A total of 112 patients with peripheral vertigo were retrospectively analyzed. All the patients firstly underwent the inspection of SOT followed by caloric test. The results were conducted a comparative analysis. Assessments of SOT evaluated the patient's effective use of visual, vestibular, and somatosensory information for balance control during a variety of changing task conditions. The unilateral weakness was selected as assessment parameter of caloric test. Fourty-two healthy subjects were selected as control group underwent the dynamic posturography.Among the 42 cases of control group, results of SOT in dynamic posturography were normal. The SOT composite scores owned a significant difference between control and peripheral vertigo subjects. Among the 112 cases with peripheral vertigo, results of SOT in dynamic posturography were abnormal in 37 cases, with a sensitivity of 33.0%; caloric test was abnormal in 72 cases, with a sensitivity of 64.3%. There existed a significant difference between dynamic posturography and caloric test.SOT is a key test in dynamic posturography that reflects the balance reconstruction after peripheral injury, and provides information about the integration and proportion of the visual, proprioceptive, and vestibular components of balance.

The aim of this study was to evaluate the effects of obstructive sleep apnea-hypopnea syndrome (OSAHS) on semicircular canal function.By means of a series prospective study at Department of Otolaryngology Head and Neck Surgery of our hospital, the study was performed on 77 patients suffering from OSAHS in a period from 2012 to 2014, who underwent polysomnography (PSG) and caloric test. The maximal slow-phase velocity (SPV) and unilateral weakness (UW) were used to measure the vestibular function. Severity of OSAHS was evaluated by the lowest oxygen saturation (LSaO₂) and apnea hypopnea index (AHI). The SPV after cool was signed, warm test was performed for each ear, and the sum of left ear SPV were calculated, and then, the SPV of right ear was counted as the same way. Finally, the relationships between LSaO₂, AHI, age, BMI, and SPV of caloric test were analyzed.Caloric vestibular tests in the 77 OSAHS patients demonstrated abnormal findings in 52 patients (67.5%) and normal vestibular functions in the remaining 25 patients (32.5%). Of the 52 patients with an abnormal test result, 16 (20.8%) patients had unilateral vestibular hyporeflexia and 36 (46.7%) patients revealed a bilateral vestibular hyporeflexia. There was no linear relationship between AHI, age, BMI with SPV of caloric test (P0.05). The SPV had significant difference between Lower LSaO₂group (LSaO₂50%) and higher LSaO₂group (LSaO₂≥ 80%) (P0.05). LSaO₂was lower in patients undertaken bilateral vestibular hyporeflexia.OSAHS patients with long-term intermittent hypoxia can disturb the vestibular organs and reduce semicircular canal function. The heavier hypoxemia will lead to the lower reflex of semicircular canal, with the heavier degree of hypoxemia, and the bilateral horizontal semicircular canal involvement may also be higher at the same time. Due to the effect of vestibule centre compensatory, OSAHS patients lack of dizziness and symptoms from balance disturbances such as typically acute vestibular damage.

To discuss the video head impulse tests (vHIT) application values in assessment of the vestibular nerves, function in sudden deafness patients with vertigo.There were 60 cases (120 ears) of healthy volunteers as control group, and 182 cases (182 ears) of sudden deafness with vertigo patients as study group. The study group received vHIT and caloric test, and the control group received vHIT. Functions of vestibular superior and inferior nerves were analyzed by the gains of vHIT and the nystagmus, s unilateral weakness of caloric test, with SPSS17.0 software.The values of vHIT-G of the six semicircular canals in the control group were normal distribution and no statistical significance among them (F = 0.005, P = 1.000). The vHIT-G averages of both sides of anterior, horizontal and posterior semicircular canals were (15.20 ± 11.00) %, (15.30 ± 13.30) %, and (15.15 ± 14.72) % respectively. In the study group, the vHIT-G of the affected side were (21.73 ± 14.84) %, (21.20 ± 28.24) %, and (19.22 ± 23.50) %, with normal distribution, and in which statistical significance was detected comparing with those in the control group (P0.05). The positive rates were 26.9% (49/182) in vHIT, 70.3% (128/182) in caloric test. Significant difference (P0.05) was observed between vHIT and caloric test examined by chi-square test. According to the results of vHIT, there were 15 cases (8.2%) damaged vestibular superior and inferior nerves areas, 19 cases (10.4%) damaged the superior vestibular nerve area, and 15 cases (8.2%) damaged the inferior vestibular nerve area. In combination with caloric test results, it was shown that there were 29 cases (15.9%) damaged vestibular superior and inferior nerves areas, 101 cases (55.5%) damaged the superior vestibular nerve area, and 1 case (0.5%) damaged the inferior vestibular nerve area.vHIT can assess the function of six semicircular canals and illustrate high frequency of vestibular nerves. Caloric test combined with vHIT have more advantages to comprehensive assess vestibular damage of sudden deafness patients with vertigo.