Purpose: This study investigated the anatomical and histological characteristics of the rat Eustachian tube(E-tube)and the feasibility of Eustachian tubography in a rat model.Materials and methods: Fifteen male Wistar...Purpose: This study investigated the anatomical and histological characteristics of the rat Eustachian tube(E-tube)and the feasibility of Eustachian tubography in a rat model.Materials and methods: Fifteen male Wistar rats were used in this study, and the bilateral E-tubes of each rat were examined. Ten E-tubes were used for anatomical studies, another ten for histological analysis, and the other ten for Eustachian tubography. Five rats were euthanized and decapitated, and ten E-tubes were dissected to describe the anatomy of the E-tube. Ten E-tube specimens obtained from five other rats were sectioned to investigate Etube histology. Eustachian tubography was performed on the bilateral E-tubes of the other five rats using the trans-tympanic approach.Results: The rat E-tubes consisted of bony and membranous parts. Cartilage and bone tissue covered only the bony part. The E-tubes’ mean diameter and overall length were 2.97 mm and 4.96 mm, respectively. The tympanic orifices’ mean diameter was 1.21 mm. The epithelium of E-tubes was mainly composed of pseudostratified ciliated and goblet cells. Eustachian tubography was successfully performed on both sides of the E-tube for each rat.The technical success rate was 100%, the average running time was 4.9 min, and no procedure-related complications occurred. On tubography images, the E-tube, tympanic cavity, and nasopharynx could be identified because of the visualization of bony landmarks.Conclusion: In this study, we described the anatomical and histological features of rat E-tubes. With the aid of these findings, E-tube angiography was successfully performed using a transtympanic approach. These results will facilitate further investigation of E-tube dysfunction.展开更多
BACKGROUND Mature teratoma composed of all three basic germ cell layers of the head and neck is a rare disease.Teratomas involving the temporal bone are particularly scarce.CASE SUMMARY A 48-year-old male patient with...BACKGROUND Mature teratoma composed of all three basic germ cell layers of the head and neck is a rare disease.Teratomas involving the temporal bone are particularly scarce.CASE SUMMARY A 48-year-old male patient with a history of chronic otitis of the left ear from infancy,for which he had been operated on twice,was referred to our hospital for chronic otitis,cholesteatoma and a middle ear mass.Computed tomography(CT)scan and magnetic resonance imaging(MRI)revealed a eustachian tube teratoma,in which the anterior lower part and posterior upper part were connected by a thin membranaceous tissue.The mass was removed completely under general anesthesia by mastoidectomy.As of last follow-up(2 years post-surgery),the disease had not relapsed.CONCLUSION Pre-operative CT and MRI are necessary for eustachian tube teratoma.Complete surgical resection provided excellent prognosis.展开更多
BACKGROUND Relapsing polychondritis(RP)is a rare inflammatory disease involving the systemic cartilage,such as the auricle,trachea,and bronchiole,among others.A patient with RP shows variable symptoms based on the inv...BACKGROUND Relapsing polychondritis(RP)is a rare inflammatory disease involving the systemic cartilage,such as the auricle,trachea,and bronchiole,among others.A patient with RP shows variable symptoms based on the involved cartilage.CASE SUMMARY A 72-year-old Japanese woman with a history of redness of the bilateral auricles for 3 d was referred to a clinician.The clinician prescribed antibiotics to the patient;however,the symptoms worsened;thus,she was referred to our hospital.Head and neck magnetic resonance imaging(MRI)showed edematous auricle with remarkable contrast,fluid collection in the bilateral mastoid cells,suggesting otitis media.The eustachian tube(ET)on the right side was also edematous with contrast enhancement.The patient was suspected of RP according to the diagnostic criteria.A biopsy of the auricular cartilage was performed by an otorhinolaryngologist,confirming pathological proof of RP.Treatments with steroids were immediately administered thereafter.CONCLUSION We highlight a rare case of RP with radiologically confirmed involvement of ET in the MRI.展开更多
Objective: To report outcomes of balloon dilation Eustachian tuboplasty combined with tympanostomy tube insertion and middle ear pressure equalization therapy in treatment of recurrent secretory otitis media. Methods:...Objective: To report outcomes of balloon dilation Eustachian tuboplasty combined with tympanostomy tube insertion and middle ear pressure equalization therapy in treatment of recurrent secretory otitis media. Methods: Fifty one patients with recurrent secretory otitis media (62 ears) underwent balloon dilation of Eustachian tube and tympanic tube insertion under general anesthesia, followed by long term middle ear pressure equalization therapies. The Eustachian tube score (ETS) and Eustachian tube function questionnaire (ETDQ-7) were used for pre- and postoperative (up to 12 months) evaluation of Eustachian tube functions. Results: The mean ETS score was 2.34 ± 0.97 preoperatively, and 6.17 ± 1.54, 7.23 ± 1.62, 8.24 ± 1.97, and 7.63 ± 1.86 at 1, 3, 6 and 12 months postoperatively, respectively (P < 0.05). The ETDQ-7 score was 4.82 ± 1.07 preoperatively, and 2.20 ± 0.54, 2.32 ± 0.68, 2.53 ± 0.79, and 2.67 ± 0.76 at 1, 3, 6 and 12 months postoperatively, respectively (P < 0.05). Conclusion: Balloon dilation of Eustachian tube combined with tympanostomy and catheterization resulted in significant improvement of subjective symptoms and objective evaluation of Eustachian tube functions in most patients with recurrent secretory otitis media, as indicated by the ETS and ETDQ-7 scores, demonstrating high levels of efficacy and patient satisfaction.展开更多
Objective To investigate the effect of exogenous surfactant on Eustachian tube opening function. Methods This reasarch measures for the Eustachian tube opening pressure by injection of surface active substance into mi...Objective To investigate the effect of exogenous surfactant on Eustachian tube opening function. Methods This reasarch measures for the Eustachian tube opening pressure by injection of surface active substance into middle ear space, studying the effect of surfactant on Eustachian tube opening function. Results It has been showed that the injection of killed streptococcus pneumoneac bacteria by the transtympanic route, successfully developed a secretory otitis media model. Eustachian tube opening pressure in ears with SOM was significantly greater than those without effusion ( P <0.01). Irrigation the middle ear space with surfactant resulted in a dramatic decrease in eustachian tube passive opening pressure in both normal and patients ( P <0.01). Conclusion The results indicate that flushing with exogenous surfactant by the transtympanic rote reduce of eustachian tube surface tension, and it benefits the Eustachian tube opening.展开更多
Objective: To determine Eustachian tube function in tubotympanic type of chronic ear disease and to correlate Eustachian tube function with pathological change in middle ear mucosa. Materials and Methods: A prospectiv...Objective: To determine Eustachian tube function in tubotympanic type of chronic ear disease and to correlate Eustachian tube function with pathological change in middle ear mucosa. Materials and Methods: A prospective study of the cases of tubotympanic type of chronic suppurative otitis media was undertaken. Patients were subjected to clinical examination followed by audiometry tests and impedence audiometry to determine eustachian tube functions. Patients were then subjected to myringoplasty and eustachian tube function were then reassessed post operatively. Results: In our study, out of 30 cases who underwent myringoplasty, 21 cases had successful surgical outcome and 9 cases were failed. Out of 24 cases of good Eustachian tube function, 21 cases had successful surgical outcome intends of taking up graft, absence of otorrhea and improvement in hearing. In remaining 3 cases, there was recurrence of otorrhea with central perforation. All the 6 cases with poor Eustachian tube function had surgical failure. Conclusion: The prognosis of the middle ear reconstructive surgery has direct correlation with Eustachian tube functions and Eustachian tube function tests should be a routine investigation in all the cases planned for surgical reconstruction of the middle ear.展开更多
In this article,the experimental and finite element analysis is utilized to investigate the quasi-static compression features of sandwich constructions built with tapered tubes.3D printing technology was utilized to c...In this article,the experimental and finite element analysis is utilized to investigate the quasi-static compression features of sandwich constructions built with tapered tubes.3D printing technology was utilized to create the hollow centers of the tapering tubes,with and without corrugations.The results demonstrate that the energy absorption(EA)and specific energy absorption(SEA)of the single corrugated tapered tube sandwich are 51.6% and 19.8% higher,respectively,than those of the conical tube sandwich.Furthermore,the results demonstrate that energy absorbers can benefit from corrugation in order to increase their efficiency.Additionally,the tapered corrugated tubes'resistance to oblique impacts was studied.Compared to a straight tube,the tapered tube is more resistant to oblique loads and has a lower initial peak crushing force(PCF),according to numerical simulations.After conducting a parametric study,it was discovered that the energy absorption performance of the sandwich construction is significantly affected by the amplitude,number of corrugations,and wall thickness.EA and SEA of DTS with corrugation number of 8 increased by 17.4%and 29.6%,respectively,while PCF decreased by 9.2% compared to DTS with corrugation number of 10.展开更多
Objectives:Multiple treatments are described in the literature for the treatment of chronic Eustachian tube dysfunction but high-level quality evidence seems missing to support these treatments.This systematic review ...Objectives:Multiple treatments are described in the literature for the treatment of chronic Eustachian tube dysfunction but high-level quality evidence seems missing to support these treatments.This systematic review aimed to determine and compare the safety and efficacy of Laser Eustachian tuboplasty and Microdebrider Eustachian tuboplasty as a treatment for long-term Eustachian tube dysfunction.Data sources:A total of 12 electronic databases were searched up to April 2018 for published and unpublished literature in the English language.References of included studies were checked.Methods:A systematic review was undertaken.Outcomes assessed were:primary outcomes-subjective improvement in symptoms(ETDQ-7),audiometric improvement of hearing,improvement of negative middle ear pressure noticed in tympanometry,objective improvement of tympanic membrane retraction.Secondary outcomes were-the ability to auto-insufflate Eustachian tube i.e.Valsalva manoeuvre,improved quality of life,passive tubal opening,tubomanometry,swallowing test,reduction in mucosal inflammation of Eustachian tube orifice in the nose,complications from the procedure,the need for further procedures.Results are reported in a narrative synthesis as a meta-analysis was not possible due to heterogeneous data.Results:Three studies were included.All included studies were small-scale case series(13-38 par-ticipants).Studies were conducted outside the UK.Subjective and objective improvement of Eustachian tube function was reported in all studies.But all included studies were at high risk of bias and subject to multiple limitations.No major complications were reported in either study.Conclusions:Based on current evidence,it is not possible to recommend the clinical use of either of these two interventions i.e.Laser or Microdebrider Eustachian tuboplasty.Lack of controlled studies was identified as a gap in the evidence.Future research should be directed toward designing randomised controlled trials.These trials should use strict standard methodology and reporting criteria.Future trials should make use of consensus statement document about Eustachian tube dysfunction definition,diagnostic methods,and outcome assessment criteria to design clinical trials.展开更多
BACKGROUND Since its description in 1790 by Hunter,the nasogastric tube(NGT)is commonly used in any healthcare setting for alleviating gastrointestinal symptoms or enteral feeding.However,the risks associated with its...BACKGROUND Since its description in 1790 by Hunter,the nasogastric tube(NGT)is commonly used in any healthcare setting for alleviating gastrointestinal symptoms or enteral feeding.However,the risks associated with its placement are often underes-timated.Upper airway obstruction with a NGT is an uncommon but potentially life-threatening complication.NGT syndrome is characterized by the presence of an NGT,throat pain and vocal cord(VC)paralysis,usually bilateral.It is poten-tially life–threatening,and early diagnosis is the key to the prevention of fatal upper airway obstruction.However,fewer cases may have been reported than might have occurred,primarily due to the clinicians'unawareness.The lack of specific signs and symptoms and the inability to prove temporal relation with NGT insertion has made diagnosing the syndrome quite challenging.AIM To review and collate the data from the published case reports and case series to understand the possible risk factors,early warning signs and symptoms for timely detection to prevent the manifestation of the complete syndrome with life-threatening airway obstruction.METHODS We conducted a systematic search for this meta-summary from the database of PubMed,EMBASE,Reference Citation Analysis(https://www.referencecitation-analysis.com/)and Google scholar,from all the past studies till August 2023.The search terms included major MESH terms"Nasogastric tube","Intubation,Gastrointestinal","Vocal Cord Paralysis",and“Syndrome”.All the case reports and case series were evaluated,and the data were extracted for patient demographics,clinical symptomatology,diagnostic and therapeutic interventions,clinical course and outcomes.A datasheet for evaluation was further prepared.RESULTS Twenty-seven cases,from five case series and 13 case reports,of NGT syndrome were retrieved from our search.There was male predominance(17,62.96%),and age at presentation ranged from 28 to 86 years.Ten patients had diabetes mellitus(37.04%),and nine were hypertensive(33.33%).Only three(11.11%)patients were reported to be immunocompromised.The median time for developing symptoms after NGT insertion was 14.5 d(interquartile range 6.25-33.75 d).The most commonly reported reason for NGT insertion was acute stroke(10,37.01%)and the most commonly reported symptoms were stridor or wheezing 17(62.96%).In 77.78%of cases,bilateral VC were affected.The only treatment instituted in most patients(77.78%)was removing the NG tube.Most patients(62.96%)required tracheostomy for airway protection.But 8 of the 23 survivors recovered within five weeks and could be decannulated.Three patients were reported to have died.CONCLUSION NGT syndrome is an uncommon clinical complication of a very common clinical procedure.However,an under-reporting is possible because of misdiagnosis or lack of awareness among clinicians.Patients in early stages and with mild symptoms may be missed.Further,high variability in the presentation timing after NGT insertion makes diagnosis challenging.Early diagnosis and prompt removal of NGT may suffice in most patients,but a significant proportion of patients presenting with respiratory compromise may require tracheostomy for airway protection.展开更多
Symptoms of patulous Eustachian tube(ET),particularly autophony,can overlap with other conditions,and can arise from a variety of causes.We review the pathophysiology of“speech hyper-resonance syndromes”,and possibl...Symptoms of patulous Eustachian tube(ET),particularly autophony,can overlap with other conditions,and can arise from a variety of causes.We review the pathophysiology of“speech hyper-resonance syndromes”,and possible mechanisms,including resonances in the tympanic membrane,Eustachian tube and nasopharynx.Treatment can be directed at the eardrum or the ET depending on site of pathology.We review typical presentations,examination findings,and useful clinical tests to distinguish PET from other disorders,and our philosophy of management.展开更多
Thin-walled structures are widely used in cars due to their lightweight construction and energy-absorbing properties.However,issues such as high initial stress and lowenergy-absorbing efficiency arise.This study propo...Thin-walled structures are widely used in cars due to their lightweight construction and energy-absorbing properties.However,issues such as high initial stress and lowenergy-absorbing efficiency arise.This study proposes a novel energy-absorbing structure inwhich a straight tube is combinedwith a conical tube and a bamboo-inspired bulkhead structure is introduced.This configuration allows the conical tube to flip outward first and then fold together with the straight tube.This deformation mode absorbs more energy and less peak force than the conical tube sinking and flipping inward.Through finite element numerical simulation,the specific energy absorption capacity of the structure is increased by 26%compared to that of a regular circular cross-section tube.Finally,the impact resistance of the bionic straight tapered tube structure is further improved through multi-objective optimization,promoting the engineering application and lightweight design of hybrid cross-section tubes.展开更多
There is no unanimous consensus for indications of eustachian tube balloon dilation(ETBD).Nordic countries have relatively similar hospital organizations and treatment guidelines.Therefore,it was logical to organize a...There is no unanimous consensus for indications of eustachian tube balloon dilation(ETBD).Nordic countries have relatively similar hospital organizations and treatment guidelines.Therefore,it was logical to organize a consensus meeting of ETBD.The symposium:Nordic Experiences on Eustachian Tube Balloon Dilation,in Copenhagen,30-31 March,2017.The panellists from Denmark,Finland,Norway and Sweden and the attendees of the meeting agreed a consensus on the following issues:Candidates,Definition of Eustachian Tube Dysfunction,Diagnostic Work up,Differential Diagnosis,Contraindications,ETBD Procedure,Complications,Follow-up,and Outcomes.The article also presents the status for ETBD in each of these countries.Thereafter the consensus statement has been discussed in the national societies and meetings for ear surgeons in each of these countries.It can be assumed that surgeons in the hospitals of these Nordic countries generally follow the recommendations from the consensus meeting.展开更多
In this study,the extruded Mg-Zn-Mn-Ce-Ca alloy tube with a low compression anisotropy along the ED,45ED and TD was prepared.The effect of the second phases,initial texture and deformation behavior on this low mechani...In this study,the extruded Mg-Zn-Mn-Ce-Ca alloy tube with a low compression anisotropy along the ED,45ED and TD was prepared.The effect of the second phases,initial texture and deformation behavior on this low mechanical anisotropy was investigated.The results revealed that the alloy tube contains the high content(Mg1-xZnx)11Ce phase and the low content of Mg12Ce phase.These second phases are respectively incoherent and coherent with the Mg matrix,and their influence can be ignored.Additionally,the alloy tube exhibited a weak basal fiber texture,where the c-axis was aligned along the 0°∼30°tilt from TD to ED.Such a texture made the initial deformation(at 1.0%∼1.6%strain)of the three samples controlled by comparable basalslip.As deformation progressed(1.6∼9.0%strain),larger amounts of ETWs nucleated and gradually approached saturation in the three samples,re-orienting the c-axis to a 0°∼±30°deviation with respect to the loading directions.Meanwhile,the prismaticaand pyramidal<c+a>slips replaced the dominant deformation progressively until fracture.Eventually,the similar deformation mechanisms determined by the weak initial texture in the three samples contribute to the comparable strain hardening rates,resulting in the low compressive anisotropy of the alloy tube.展开更多
Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatm...Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatment for SSNHL after the failure of systemic steroid therapy(SST).Objective: This study aimed to analyze the efficacy of modified IST involving the insertion of a tympanic tube and gelfoam as a salvage treatment for patients with SSNHL, and to explore its associated factors.Methods: Totally, 74 patients who were aged 22–81 years with SSNHL were enrolled and allocated to either the control group(n = 25) or the treatment group(n = 49) based on their treatment modalities. All patients received SST lasting for at least 7 days. Subsequently, patients in the treatment group, after SST failure, underwent IST twice a week for 2–6 weeks, while the control group did not. Efficacy was assessed by the improvement in pure tone average at the affected frequency at the beginning and end of IST.Results: Hearing improvement in all patients after IST in the treatment group was 9.71 ± 14.84 dB, with significant improvement at affected frequencies(250-8000 Hz) compared with the control group(P < 0.05). The findings indicated the duration from the onset of SSNHL to the beginning of IST as an independent factor for pure tone average improvement after treatment(P = 0.002), whereas age, duration of SST, and time of IST were not(P > 0.05).Conclusion: The modified IST was demonstrated to be a safe and effective method as a salvage treatment for SSNHL. This study explored the efficacy of a modified IST approach, incorporating the utilization of tympanic tubes and gelfoam as key components. The findings underscore the advantages of gelfoam as a strategic drug carrier placed in the round window niche. By minimizing drug loss, extending action time, and increasing perilymph concentration, gelfoam enhances the therapeutic impact of IST, contributing to improved hearing outcomes in patients with SSNHL.展开更多
In this paper, a novel efficient energy absorber with free inversion of a metal foam-filled circular tube(MFFCT) is designed, and the axial compressive behavior of the MFFCT under free inversion is studied analyticall...In this paper, a novel efficient energy absorber with free inversion of a metal foam-filled circular tube(MFFCT) is designed, and the axial compressive behavior of the MFFCT under free inversion is studied analytically and numerically. The theoretical analysis reveals that the energy is mainly dissipated through the radial bending of the metal circular tube, the circumferential expansion of the metal circular tube, and the metal filled-foam compression. The principle of energy conservation is used to derive the theoretical formula for the minimum compressive force of the MFFCT over free inversion under axial loading. Furthermore, the free inversion deformation characteristics of the MFFCT are analyzed numerically. The theoretical steady values are found to be in good agreement with the results of the finite element(FE) analysis. The effects of the average diameter of the metal tube, the wall thickness of the metal tube, and the filled-foam strength on the free inversion deformation of the MFFCT are considered. It is observed that in the steady deformation stage, the load-carrying and energy-absorbing capacities of the MFFCT increase with the increase in the average diameter of the metal tube, the wall thickness of the metal tube, or the filled-foam strength. The specific energy absorption(SEA) of free inversion of the MFFCT is significantly higher than that of the metal tube alone.展开更多
Aluminum alloy thin-walled structures are widely used in the automotive industry due to their advantages related to light weight and crashworthiness.They can be produced at room temperature by the electrohydraulic for...Aluminum alloy thin-walled structures are widely used in the automotive industry due to their advantages related to light weight and crashworthiness.They can be produced at room temperature by the electrohydraulic forming process.In the present study,the influence of the related parameters on the forming quality of a 6063 aluminum alloy sinusoidal corrugation tube has been assessed.In particular,the orthogonal experimental design(OED)and central composite design(CCD)methods have been used.Through the range analysis and variance analysis of the experimental data,the influence degree of wire diameter(WD)and discharge energy(DE)on the forming quality was determined.Multiple regression analysis was performed using the response surface methodology.A prediction model for the attaching-die state coefficient was established accordingly.The following optimal arrangement of parameters was obtained(WD=0.759 mm,DE=2.926 kJ).The attaching-die state coefficient reached the peak value of 0.001.Better optimized wire diameter and discharge energy for a better attaching-die state could be screened by CCD compared with OED.The response surface method in CCD was more suitable for the design and optimization of the considered process parameters.展开更多
The radiant tube burner was modeled and analyzed by the numerical simulation method to investigate the influence factors and rules of NO_(x) emissions in a W-type radiant tube.These factors,which include air preheatin...The radiant tube burner was modeled and analyzed by the numerical simulation method to investigate the influence factors and rules of NO_(x) emissions in a W-type radiant tube.These factors,which include air preheating temperature,excess air coefficient,and fuel gas composition,were modified to study their effects on NO_(x) emissions under varying working conditions.Simulation results were compared with the theoretical calculation value based on chemical reaction equilibrium theory and the onsite experimental value to verify the simulation accuracy.The results show that NO_(x) emissions rise with increasing air preheating temperatures.NO_(x) production increases to an extreme value and then decreases during the oxygen-poor to oxygen-enriched process with the rise of the excess air coefficient.Enhancing the proportion of coke oven gas in the fuel gas raises the combustion temperature as well as the NO_(x) discharge.Both the thermal efficiency and NO_(x) emissions should be balanced.Therefore,the recommended values based on the simulation results are as follows:the air preheating temperature should not exceed 400℃,the excess air coefficient should be between 1.1 and 1.2,and the volume fraction of the coke oven gas should not exceed 30%.展开更多
GH984G alloy is a significant candidate material for 650-700℃ ultra-supercritical coal-fired generating units.In this paper,creep rupture properties and microstructure stability of the GH984G alloy tube were studied,...GH984G alloy is a significant candidate material for 650-700℃ ultra-supercritical coal-fired generating units.In this paper,creep rupture properties and microstructure stability of the GH984G alloy tube were studied,and the findings indicated excellent creep rupture properties at 700℃.Furthermore,the extrapolated strength for 100000 h was found to be 153.8 MPa,which satisfies the requirements for the long-term performance of high-temperature materials in power stations.Aging at 700℃ with the extension of time,the grain boundary carbides and the particle size of the γ′phase on the matrix gradually coarsen,but its spherical morphology remains uniformly distributed.However,no harmful phase precipitates were found even after aging at 700℃ for up to 19144 h.Excellent microstructure stability guarantees the 700℃ creep rupture properties of the GH984G alloy tube.展开更多
BACKGROUND The neuroendoscopic approach has the advantages of a clear operative field,convenient tumor removal,and less damage,and is the development direction of modern neurosurgery.At present,transnasal surgery for ...BACKGROUND The neuroendoscopic approach has the advantages of a clear operative field,convenient tumor removal,and less damage,and is the development direction of modern neurosurgery.At present,transnasal surgery for sphenoidal pituitary tumor is widely used.But it has been found in clinical practice that some patients with this type of surgery may experience post-operative nausea and vomiting and other discomforts.AIM To explore the effect of reserved gastric tube application in the neuroendoscopic endonasal resection of pituitary tumors.METHODS A total of 60 patients who underwent pituitary adenoma resection via the endoscopic endonasal approach were selected and randomly divided into the experimental and control groups,with 30 in each group.Experimental group:After anesthesia,a gastric tube was placed through the mouth under direct vision using a visual laryngoscope,and the fluid accumulated in the oropharynx was suctioned intermittently with low negative pressure throughout the whole process after nasal disinfection,during the operation,and when the patient recovered from anesthesia.Control group:Given the routine intraoperative care,no gastric tube was left.The number of cases of nausea/vomiting/aspiration within 24 h post-operation was counted and compared between the two groups;the scores of pharyngalgia after waking up,6 h post-operation,and 24 h postoperation.The frequency of postoperative cerebrospinal fluid leakage and intracranial infection were compared.The hospitalization days of the two groups were statistically compared.RESULTS The times of postoperative nausea and vomiting in the experimental group were lower than that in the control group,and the difference in the incidence of nausea was statistically significant(P<0.05).After the patient woke up,the scores of sore throat 6 h after the operation and 24 h after operation were lower than those in the control group,and the difference was statistically significant(P<0.05).The number of cases of postoperative cerebrospinal fluid leakage and intracranial infection was higher than that of the control group,but there was no statistically significant difference from the control group(P>0.05).The hospitalization days of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).CONCLUSION Reserving a gastric tube in the endoscopic endonasal resection of pituitary tumors,combined with intraoperative and postoperative gastrointestinal decompression,can effectively reduce the incidence of nausea,reduce the number of vomiting and aspiration in patients,and reduce the complications of sore throat The incidence rate shortened the hospitalization days of the patients.展开更多
Objective:To evaluate the significance of Eustachian tube(ET)angles and ET pretympanic diameter on high resolution computed tomography(HRCT)Temporal bone in patients with chronic otitis media(COM).Methods:A retrospect...Objective:To evaluate the significance of Eustachian tube(ET)angles and ET pretympanic diameter on high resolution computed tomography(HRCT)Temporal bone in patients with chronic otitis media(COM).Methods:A retrospective study was carried out at Tertiary care centre.Group A included 92 ears with COM(38 patients with bilateral COM and 16 with unilateral COM);and Group B included 108 normal ears(54 patients with bilateral normal ears).Reid plane-ET angle,Tubotympanic angle and the ET pretympanic diameter was evaluated by HRCT temporal bone,and compared in the two groups.Patients with chronic otitis media(Group A)were subdivided into Group A1(Blocked ET)and Group A2(Patent ET).The parameters were evaluated and compared in the subgroups too.Results:The mean Reid plane-ET angle and Tubotympanic angle in Group A was 25.412.57 and 148.123.43 respectively;whereas in Group B it was 27.563.62 and 145.144.34 respectively.Reid plane-ET angle was significantly less in patients with COM and Tubotympanic angle was significantly more obtuse in COM patients.ET pretympanic diameter was(5.372.10)mm in Group A and(6.472.40)mm in Group B.It was significantly less in patients with COM.A significant correlation was found between the ET patency and the two ET parameters(Reid plane-ET angle and pretympanic diameter).Conclusions:Eustachian tube angles in adults may play a significant role in the etiology of chronic otitis media.Decrease in Reid plane-ET angle and pretympanic diameter on HRCT temporal bone can be used to predict ET dysfunction and to plan the surgical management of chronic otitis media.展开更多
基金funding from the Korea Health Technology R&D Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (HI17C0881)。
文摘Purpose: This study investigated the anatomical and histological characteristics of the rat Eustachian tube(E-tube)and the feasibility of Eustachian tubography in a rat model.Materials and methods: Fifteen male Wistar rats were used in this study, and the bilateral E-tubes of each rat were examined. Ten E-tubes were used for anatomical studies, another ten for histological analysis, and the other ten for Eustachian tubography. Five rats were euthanized and decapitated, and ten E-tubes were dissected to describe the anatomy of the E-tube. Ten E-tube specimens obtained from five other rats were sectioned to investigate Etube histology. Eustachian tubography was performed on the bilateral E-tubes of the other five rats using the trans-tympanic approach.Results: The rat E-tubes consisted of bony and membranous parts. Cartilage and bone tissue covered only the bony part. The E-tubes’ mean diameter and overall length were 2.97 mm and 4.96 mm, respectively. The tympanic orifices’ mean diameter was 1.21 mm. The epithelium of E-tubes was mainly composed of pseudostratified ciliated and goblet cells. Eustachian tubography was successfully performed on both sides of the E-tube for each rat.The technical success rate was 100%, the average running time was 4.9 min, and no procedure-related complications occurred. On tubography images, the E-tube, tympanic cavity, and nasopharynx could be identified because of the visualization of bony landmarks.Conclusion: In this study, we described the anatomical and histological features of rat E-tubes. With the aid of these findings, E-tube angiography was successfully performed using a transtympanic approach. These results will facilitate further investigation of E-tube dysfunction.
基金Shandong Province Key Research and Development Program Project,No.2018GSF118041Shandong Medical and Health Science and Technology Development Plan,No.2017WS740.
文摘BACKGROUND Mature teratoma composed of all three basic germ cell layers of the head and neck is a rare disease.Teratomas involving the temporal bone are particularly scarce.CASE SUMMARY A 48-year-old male patient with a history of chronic otitis of the left ear from infancy,for which he had been operated on twice,was referred to our hospital for chronic otitis,cholesteatoma and a middle ear mass.Computed tomography(CT)scan and magnetic resonance imaging(MRI)revealed a eustachian tube teratoma,in which the anterior lower part and posterior upper part were connected by a thin membranaceous tissue.The mass was removed completely under general anesthesia by mastoidectomy.As of last follow-up(2 years post-surgery),the disease had not relapsed.CONCLUSION Pre-operative CT and MRI are necessary for eustachian tube teratoma.Complete surgical resection provided excellent prognosis.
文摘BACKGROUND Relapsing polychondritis(RP)is a rare inflammatory disease involving the systemic cartilage,such as the auricle,trachea,and bronchiole,among others.A patient with RP shows variable symptoms based on the involved cartilage.CASE SUMMARY A 72-year-old Japanese woman with a history of redness of the bilateral auricles for 3 d was referred to a clinician.The clinician prescribed antibiotics to the patient;however,the symptoms worsened;thus,she was referred to our hospital.Head and neck magnetic resonance imaging(MRI)showed edematous auricle with remarkable contrast,fluid collection in the bilateral mastoid cells,suggesting otitis media.The eustachian tube(ET)on the right side was also edematous with contrast enhancement.The patient was suspected of RP according to the diagnostic criteria.A biopsy of the auricular cartilage was performed by an otorhinolaryngologist,confirming pathological proof of RP.Treatments with steroids were immediately administered thereafter.CONCLUSION We highlight a rare case of RP with radiologically confirmed involvement of ET in the MRI.
基金supported by the Guangzhou Science and Technology Project (Industrial, Academic and Research Collaborative Innovation Project):201803010093the major development projects of sun yat-sen university: 201812281965
文摘Objective: To report outcomes of balloon dilation Eustachian tuboplasty combined with tympanostomy tube insertion and middle ear pressure equalization therapy in treatment of recurrent secretory otitis media. Methods: Fifty one patients with recurrent secretory otitis media (62 ears) underwent balloon dilation of Eustachian tube and tympanic tube insertion under general anesthesia, followed by long term middle ear pressure equalization therapies. The Eustachian tube score (ETS) and Eustachian tube function questionnaire (ETDQ-7) were used for pre- and postoperative (up to 12 months) evaluation of Eustachian tube functions. Results: The mean ETS score was 2.34 ± 0.97 preoperatively, and 6.17 ± 1.54, 7.23 ± 1.62, 8.24 ± 1.97, and 7.63 ± 1.86 at 1, 3, 6 and 12 months postoperatively, respectively (P < 0.05). The ETDQ-7 score was 4.82 ± 1.07 preoperatively, and 2.20 ± 0.54, 2.32 ± 0.68, 2.53 ± 0.79, and 2.67 ± 0.76 at 1, 3, 6 and 12 months postoperatively, respectively (P < 0.05). Conclusion: Balloon dilation of Eustachian tube combined with tympanostomy and catheterization resulted in significant improvement of subjective symptoms and objective evaluation of Eustachian tube functions in most patients with recurrent secretory otitis media, as indicated by the ETS and ETDQ-7 scores, demonstrating high levels of efficacy and patient satisfaction.
文摘Objective To investigate the effect of exogenous surfactant on Eustachian tube opening function. Methods This reasarch measures for the Eustachian tube opening pressure by injection of surface active substance into middle ear space, studying the effect of surfactant on Eustachian tube opening function. Results It has been showed that the injection of killed streptococcus pneumoneac bacteria by the transtympanic route, successfully developed a secretory otitis media model. Eustachian tube opening pressure in ears with SOM was significantly greater than those without effusion ( P <0.01). Irrigation the middle ear space with surfactant resulted in a dramatic decrease in eustachian tube passive opening pressure in both normal and patients ( P <0.01). Conclusion The results indicate that flushing with exogenous surfactant by the transtympanic rote reduce of eustachian tube surface tension, and it benefits the Eustachian tube opening.
文摘Objective: To determine Eustachian tube function in tubotympanic type of chronic ear disease and to correlate Eustachian tube function with pathological change in middle ear mucosa. Materials and Methods: A prospective study of the cases of tubotympanic type of chronic suppurative otitis media was undertaken. Patients were subjected to clinical examination followed by audiometry tests and impedence audiometry to determine eustachian tube functions. Patients were then subjected to myringoplasty and eustachian tube function were then reassessed post operatively. Results: In our study, out of 30 cases who underwent myringoplasty, 21 cases had successful surgical outcome and 9 cases were failed. Out of 24 cases of good Eustachian tube function, 21 cases had successful surgical outcome intends of taking up graft, absence of otorrhea and improvement in hearing. In remaining 3 cases, there was recurrence of otorrhea with central perforation. All the 6 cases with poor Eustachian tube function had surgical failure. Conclusion: The prognosis of the middle ear reconstructive surgery has direct correlation with Eustachian tube functions and Eustachian tube function tests should be a routine investigation in all the cases planned for surgical reconstruction of the middle ear.
基金the grants from the National Natural Science Foundation of China(Nos.52078152 and 12002095)Guangzhou Government-University Union Fund(No.202201020532)。
文摘In this article,the experimental and finite element analysis is utilized to investigate the quasi-static compression features of sandwich constructions built with tapered tubes.3D printing technology was utilized to create the hollow centers of the tapering tubes,with and without corrugations.The results demonstrate that the energy absorption(EA)and specific energy absorption(SEA)of the single corrugated tapered tube sandwich are 51.6% and 19.8% higher,respectively,than those of the conical tube sandwich.Furthermore,the results demonstrate that energy absorbers can benefit from corrugation in order to increase their efficiency.Additionally,the tapered corrugated tubes'resistance to oblique impacts was studied.Compared to a straight tube,the tapered tube is more resistant to oblique loads and has a lower initial peak crushing force(PCF),according to numerical simulations.After conducting a parametric study,it was discovered that the energy absorption performance of the sandwich construction is significantly affected by the amplitude,number of corrugations,and wall thickness.EA and SEA of DTS with corrugation number of 8 increased by 17.4%and 29.6%,respectively,while PCF decreased by 9.2% compared to DTS with corrugation number of 10.
文摘Objectives:Multiple treatments are described in the literature for the treatment of chronic Eustachian tube dysfunction but high-level quality evidence seems missing to support these treatments.This systematic review aimed to determine and compare the safety and efficacy of Laser Eustachian tuboplasty and Microdebrider Eustachian tuboplasty as a treatment for long-term Eustachian tube dysfunction.Data sources:A total of 12 electronic databases were searched up to April 2018 for published and unpublished literature in the English language.References of included studies were checked.Methods:A systematic review was undertaken.Outcomes assessed were:primary outcomes-subjective improvement in symptoms(ETDQ-7),audiometric improvement of hearing,improvement of negative middle ear pressure noticed in tympanometry,objective improvement of tympanic membrane retraction.Secondary outcomes were-the ability to auto-insufflate Eustachian tube i.e.Valsalva manoeuvre,improved quality of life,passive tubal opening,tubomanometry,swallowing test,reduction in mucosal inflammation of Eustachian tube orifice in the nose,complications from the procedure,the need for further procedures.Results are reported in a narrative synthesis as a meta-analysis was not possible due to heterogeneous data.Results:Three studies were included.All included studies were small-scale case series(13-38 par-ticipants).Studies were conducted outside the UK.Subjective and objective improvement of Eustachian tube function was reported in all studies.But all included studies were at high risk of bias and subject to multiple limitations.No major complications were reported in either study.Conclusions:Based on current evidence,it is not possible to recommend the clinical use of either of these two interventions i.e.Laser or Microdebrider Eustachian tuboplasty.Lack of controlled studies was identified as a gap in the evidence.Future research should be directed toward designing randomised controlled trials.These trials should use strict standard methodology and reporting criteria.Future trials should make use of consensus statement document about Eustachian tube dysfunction definition,diagnostic methods,and outcome assessment criteria to design clinical trials.
文摘BACKGROUND Since its description in 1790 by Hunter,the nasogastric tube(NGT)is commonly used in any healthcare setting for alleviating gastrointestinal symptoms or enteral feeding.However,the risks associated with its placement are often underes-timated.Upper airway obstruction with a NGT is an uncommon but potentially life-threatening complication.NGT syndrome is characterized by the presence of an NGT,throat pain and vocal cord(VC)paralysis,usually bilateral.It is poten-tially life–threatening,and early diagnosis is the key to the prevention of fatal upper airway obstruction.However,fewer cases may have been reported than might have occurred,primarily due to the clinicians'unawareness.The lack of specific signs and symptoms and the inability to prove temporal relation with NGT insertion has made diagnosing the syndrome quite challenging.AIM To review and collate the data from the published case reports and case series to understand the possible risk factors,early warning signs and symptoms for timely detection to prevent the manifestation of the complete syndrome with life-threatening airway obstruction.METHODS We conducted a systematic search for this meta-summary from the database of PubMed,EMBASE,Reference Citation Analysis(https://www.referencecitation-analysis.com/)and Google scholar,from all the past studies till August 2023.The search terms included major MESH terms"Nasogastric tube","Intubation,Gastrointestinal","Vocal Cord Paralysis",and“Syndrome”.All the case reports and case series were evaluated,and the data were extracted for patient demographics,clinical symptomatology,diagnostic and therapeutic interventions,clinical course and outcomes.A datasheet for evaluation was further prepared.RESULTS Twenty-seven cases,from five case series and 13 case reports,of NGT syndrome were retrieved from our search.There was male predominance(17,62.96%),and age at presentation ranged from 28 to 86 years.Ten patients had diabetes mellitus(37.04%),and nine were hypertensive(33.33%).Only three(11.11%)patients were reported to be immunocompromised.The median time for developing symptoms after NGT insertion was 14.5 d(interquartile range 6.25-33.75 d).The most commonly reported reason for NGT insertion was acute stroke(10,37.01%)and the most commonly reported symptoms were stridor or wheezing 17(62.96%).In 77.78%of cases,bilateral VC were affected.The only treatment instituted in most patients(77.78%)was removing the NG tube.Most patients(62.96%)required tracheostomy for airway protection.But 8 of the 23 survivors recovered within five weeks and could be decannulated.Three patients were reported to have died.CONCLUSION NGT syndrome is an uncommon clinical complication of a very common clinical procedure.However,an under-reporting is possible because of misdiagnosis or lack of awareness among clinicians.Patients in early stages and with mild symptoms may be missed.Further,high variability in the presentation timing after NGT insertion makes diagnosis challenging.Early diagnosis and prompt removal of NGT may suffice in most patients,but a significant proportion of patients presenting with respiratory compromise may require tracheostomy for airway protection.
文摘Symptoms of patulous Eustachian tube(ET),particularly autophony,can overlap with other conditions,and can arise from a variety of causes.We review the pathophysiology of“speech hyper-resonance syndromes”,and possible mechanisms,including resonances in the tympanic membrane,Eustachian tube and nasopharynx.Treatment can be directed at the eardrum or the ET depending on site of pathology.We review typical presentations,examination findings,and useful clinical tests to distinguish PET from other disorders,and our philosophy of management.
文摘Thin-walled structures are widely used in cars due to their lightweight construction and energy-absorbing properties.However,issues such as high initial stress and lowenergy-absorbing efficiency arise.This study proposes a novel energy-absorbing structure inwhich a straight tube is combinedwith a conical tube and a bamboo-inspired bulkhead structure is introduced.This configuration allows the conical tube to flip outward first and then fold together with the straight tube.This deformation mode absorbs more energy and less peak force than the conical tube sinking and flipping inward.Through finite element numerical simulation,the specific energy absorption capacity of the structure is increased by 26%compared to that of a regular circular cross-section tube.Finally,the impact resistance of the bionic straight tapered tube structure is further improved through multi-objective optimization,promoting the engineering application and lightweight design of hybrid cross-section tubes.
文摘There is no unanimous consensus for indications of eustachian tube balloon dilation(ETBD).Nordic countries have relatively similar hospital organizations and treatment guidelines.Therefore,it was logical to organize a consensus meeting of ETBD.The symposium:Nordic Experiences on Eustachian Tube Balloon Dilation,in Copenhagen,30-31 March,2017.The panellists from Denmark,Finland,Norway and Sweden and the attendees of the meeting agreed a consensus on the following issues:Candidates,Definition of Eustachian Tube Dysfunction,Diagnostic Work up,Differential Diagnosis,Contraindications,ETBD Procedure,Complications,Follow-up,and Outcomes.The article also presents the status for ETBD in each of these countries.Thereafter the consensus statement has been discussed in the national societies and meetings for ear surgeons in each of these countries.It can be assumed that surgeons in the hospitals of these Nordic countries generally follow the recommendations from the consensus meeting.
基金supported by the National Natural Science Foundation of China(Nos.51974082,51901037)State Key Laboratory of Baiyunobo Rare Earth Resource Research and Comprehensive Utilization(No.2021H2279)Programme of Introducing Talents of Discipline Innovation to Universities 2.0(the 111 Project 2.0 of China,No.BP0719037).
文摘In this study,the extruded Mg-Zn-Mn-Ce-Ca alloy tube with a low compression anisotropy along the ED,45ED and TD was prepared.The effect of the second phases,initial texture and deformation behavior on this low mechanical anisotropy was investigated.The results revealed that the alloy tube contains the high content(Mg1-xZnx)11Ce phase and the low content of Mg12Ce phase.These second phases are respectively incoherent and coherent with the Mg matrix,and their influence can be ignored.Additionally,the alloy tube exhibited a weak basal fiber texture,where the c-axis was aligned along the 0°∼30°tilt from TD to ED.Such a texture made the initial deformation(at 1.0%∼1.6%strain)of the three samples controlled by comparable basalslip.As deformation progressed(1.6∼9.0%strain),larger amounts of ETWs nucleated and gradually approached saturation in the three samples,re-orienting the c-axis to a 0°∼±30°deviation with respect to the loading directions.Meanwhile,the prismaticaand pyramidal<c+a>slips replaced the dominant deformation progressively until fracture.Eventually,the similar deformation mechanisms determined by the weak initial texture in the three samples contribute to the comparable strain hardening rates,resulting in the low compressive anisotropy of the alloy tube.
文摘Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatment for SSNHL after the failure of systemic steroid therapy(SST).Objective: This study aimed to analyze the efficacy of modified IST involving the insertion of a tympanic tube and gelfoam as a salvage treatment for patients with SSNHL, and to explore its associated factors.Methods: Totally, 74 patients who were aged 22–81 years with SSNHL were enrolled and allocated to either the control group(n = 25) or the treatment group(n = 49) based on their treatment modalities. All patients received SST lasting for at least 7 days. Subsequently, patients in the treatment group, after SST failure, underwent IST twice a week for 2–6 weeks, while the control group did not. Efficacy was assessed by the improvement in pure tone average at the affected frequency at the beginning and end of IST.Results: Hearing improvement in all patients after IST in the treatment group was 9.71 ± 14.84 dB, with significant improvement at affected frequencies(250-8000 Hz) compared with the control group(P < 0.05). The findings indicated the duration from the onset of SSNHL to the beginning of IST as an independent factor for pure tone average improvement after treatment(P = 0.002), whereas age, duration of SST, and time of IST were not(P > 0.05).Conclusion: The modified IST was demonstrated to be a safe and effective method as a salvage treatment for SSNHL. This study explored the efficacy of a modified IST approach, incorporating the utilization of tympanic tubes and gelfoam as key components. The findings underscore the advantages of gelfoam as a strategic drug carrier placed in the round window niche. By minimizing drug loss, extending action time, and increasing perilymph concentration, gelfoam enhances the therapeutic impact of IST, contributing to improved hearing outcomes in patients with SSNHL.
基金Project supported by the National Natural Science Foundation of China (Nos. 12272290 and11872291)the State Key Laboratory of Automotive Safety and Energy of China (No. KFY2202)。
文摘In this paper, a novel efficient energy absorber with free inversion of a metal foam-filled circular tube(MFFCT) is designed, and the axial compressive behavior of the MFFCT under free inversion is studied analytically and numerically. The theoretical analysis reveals that the energy is mainly dissipated through the radial bending of the metal circular tube, the circumferential expansion of the metal circular tube, and the metal filled-foam compression. The principle of energy conservation is used to derive the theoretical formula for the minimum compressive force of the MFFCT over free inversion under axial loading. Furthermore, the free inversion deformation characteristics of the MFFCT are analyzed numerically. The theoretical steady values are found to be in good agreement with the results of the finite element(FE) analysis. The effects of the average diameter of the metal tube, the wall thickness of the metal tube, and the filled-foam strength on the free inversion deformation of the MFFCT are considered. It is observed that in the steady deformation stage, the load-carrying and energy-absorbing capacities of the MFFCT increase with the increase in the average diameter of the metal tube, the wall thickness of the metal tube, or the filled-foam strength. The specific energy absorption(SEA) of free inversion of the MFFCT is significantly higher than that of the metal tube alone.
基金supported by National Natural Science Foundation of China(Grant Nos.51975202(Junjia Cui received the grant)and 52175315(Guangyao Li received the grant)).
文摘Aluminum alloy thin-walled structures are widely used in the automotive industry due to their advantages related to light weight and crashworthiness.They can be produced at room temperature by the electrohydraulic forming process.In the present study,the influence of the related parameters on the forming quality of a 6063 aluminum alloy sinusoidal corrugation tube has been assessed.In particular,the orthogonal experimental design(OED)and central composite design(CCD)methods have been used.Through the range analysis and variance analysis of the experimental data,the influence degree of wire diameter(WD)and discharge energy(DE)on the forming quality was determined.Multiple regression analysis was performed using the response surface methodology.A prediction model for the attaching-die state coefficient was established accordingly.The following optimal arrangement of parameters was obtained(WD=0.759 mm,DE=2.926 kJ).The attaching-die state coefficient reached the peak value of 0.001.Better optimized wire diameter and discharge energy for a better attaching-die state could be screened by CCD compared with OED.The response surface method in CCD was more suitable for the design and optimization of the considered process parameters.
文摘The radiant tube burner was modeled and analyzed by the numerical simulation method to investigate the influence factors and rules of NO_(x) emissions in a W-type radiant tube.These factors,which include air preheating temperature,excess air coefficient,and fuel gas composition,were modified to study their effects on NO_(x) emissions under varying working conditions.Simulation results were compared with the theoretical calculation value based on chemical reaction equilibrium theory and the onsite experimental value to verify the simulation accuracy.The results show that NO_(x) emissions rise with increasing air preheating temperatures.NO_(x) production increases to an extreme value and then decreases during the oxygen-poor to oxygen-enriched process with the rise of the excess air coefficient.Enhancing the proportion of coke oven gas in the fuel gas raises the combustion temperature as well as the NO_(x) discharge.Both the thermal efficiency and NO_(x) emissions should be balanced.Therefore,the recommended values based on the simulation results are as follows:the air preheating temperature should not exceed 400℃,the excess air coefficient should be between 1.1 and 1.2,and the volume fraction of the coke oven gas should not exceed 30%.
文摘GH984G alloy is a significant candidate material for 650-700℃ ultra-supercritical coal-fired generating units.In this paper,creep rupture properties and microstructure stability of the GH984G alloy tube were studied,and the findings indicated excellent creep rupture properties at 700℃.Furthermore,the extrapolated strength for 100000 h was found to be 153.8 MPa,which satisfies the requirements for the long-term performance of high-temperature materials in power stations.Aging at 700℃ with the extension of time,the grain boundary carbides and the particle size of the γ′phase on the matrix gradually coarsen,but its spherical morphology remains uniformly distributed.However,no harmful phase precipitates were found even after aging at 700℃ for up to 19144 h.Excellent microstructure stability guarantees the 700℃ creep rupture properties of the GH984G alloy tube.
基金Traditional Chinese Medicine Science and Technology Project in Jiangsu Province,No.YB2015113the Science and Technology Program of Nantong Health Committee,No.MA2019003,No.MA2021017,No.MB2021026,and No.MB2021027+1 种基金Science and Technology Program of Nantong City,No.Key003,No.MS12015016 and No.JCZ2022040Kangda College of Nanjing Medical University,No.KD2021JYYJYB025,No.KD2022KYJJZD019,No.KD2022KYJJZD022,and No.2023ZC127.
文摘BACKGROUND The neuroendoscopic approach has the advantages of a clear operative field,convenient tumor removal,and less damage,and is the development direction of modern neurosurgery.At present,transnasal surgery for sphenoidal pituitary tumor is widely used.But it has been found in clinical practice that some patients with this type of surgery may experience post-operative nausea and vomiting and other discomforts.AIM To explore the effect of reserved gastric tube application in the neuroendoscopic endonasal resection of pituitary tumors.METHODS A total of 60 patients who underwent pituitary adenoma resection via the endoscopic endonasal approach were selected and randomly divided into the experimental and control groups,with 30 in each group.Experimental group:After anesthesia,a gastric tube was placed through the mouth under direct vision using a visual laryngoscope,and the fluid accumulated in the oropharynx was suctioned intermittently with low negative pressure throughout the whole process after nasal disinfection,during the operation,and when the patient recovered from anesthesia.Control group:Given the routine intraoperative care,no gastric tube was left.The number of cases of nausea/vomiting/aspiration within 24 h post-operation was counted and compared between the two groups;the scores of pharyngalgia after waking up,6 h post-operation,and 24 h postoperation.The frequency of postoperative cerebrospinal fluid leakage and intracranial infection were compared.The hospitalization days of the two groups were statistically compared.RESULTS The times of postoperative nausea and vomiting in the experimental group were lower than that in the control group,and the difference in the incidence of nausea was statistically significant(P<0.05).After the patient woke up,the scores of sore throat 6 h after the operation and 24 h after operation were lower than those in the control group,and the difference was statistically significant(P<0.05).The number of cases of postoperative cerebrospinal fluid leakage and intracranial infection was higher than that of the control group,but there was no statistically significant difference from the control group(P>0.05).The hospitalization days of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).CONCLUSION Reserving a gastric tube in the endoscopic endonasal resection of pituitary tumors,combined with intraoperative and postoperative gastrointestinal decompression,can effectively reduce the incidence of nausea,reduce the number of vomiting and aspiration in patients,and reduce the complications of sore throat The incidence rate shortened the hospitalization days of the patients.
文摘Objective:To evaluate the significance of Eustachian tube(ET)angles and ET pretympanic diameter on high resolution computed tomography(HRCT)Temporal bone in patients with chronic otitis media(COM).Methods:A retrospective study was carried out at Tertiary care centre.Group A included 92 ears with COM(38 patients with bilateral COM and 16 with unilateral COM);and Group B included 108 normal ears(54 patients with bilateral normal ears).Reid plane-ET angle,Tubotympanic angle and the ET pretympanic diameter was evaluated by HRCT temporal bone,and compared in the two groups.Patients with chronic otitis media(Group A)were subdivided into Group A1(Blocked ET)and Group A2(Patent ET).The parameters were evaluated and compared in the subgroups too.Results:The mean Reid plane-ET angle and Tubotympanic angle in Group A was 25.412.57 and 148.123.43 respectively;whereas in Group B it was 27.563.62 and 145.144.34 respectively.Reid plane-ET angle was significantly less in patients with COM and Tubotympanic angle was significantly more obtuse in COM patients.ET pretympanic diameter was(5.372.10)mm in Group A and(6.472.40)mm in Group B.It was significantly less in patients with COM.A significant correlation was found between the ET patency and the two ET parameters(Reid plane-ET angle and pretympanic diameter).Conclusions:Eustachian tube angles in adults may play a significant role in the etiology of chronic otitis media.Decrease in Reid plane-ET angle and pretympanic diameter on HRCT temporal bone can be used to predict ET dysfunction and to plan the surgical management of chronic otitis media.
