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ABSTRACT: To investigate whether patients presenting with self-reported olfactory disorders demonstrates significant side difference in odour recognition by measuring separately for each nostril.
One hundred and four patients with chief complaint of hyposmia were evaluated by medical history, physical examination, T&T olfactory testing and medical imaging. Smell was tested using T&T olfactometry in each nostril separately.
Based on the history and results from the clinical examination, unilateral sinonasal diseases and abnormal nasal structure were excluded. In almost one eighth of all presenting patients (13.46%), a side difference was detected. Especially, six of the patients were identified with lateralized hyposmia.
Olfactory testing could be performed in each nostril separately. The above findings suggested that testing each nostril separately was necessary so as not to miss unilateral hyposmia as a special clinical manifestation of olfactory disorder.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 11/2012; 47(11):945-7.
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ABSTRACT: High-density porous polyethylene (Medpor) has long been used in cranioplasty and is still one of the best materials for calvarial reconstruction. Calvarial defects can be effectively reconstructed with fewer complications by using Medpor. This article reports our study on the use of Medpor in reconstructing calvarial defects.
Twenty-three patients who underwent cranioplasty from 1999 to 2011 were included in this study. In all patients, Medpor was used for calvarial defect reconstruction, and all were followed up for at least 6 months.
Most patients were satisfied with the reconstructive outcome. Only 1 patient had an infection and 1 had transient extradural seroma. All complications occurred within 2 years, and no new complications were found during the long-term follow-up.
Using Medpor in cranioplasty is an effective method for reconstructing calvarial defects.
The Journal of craniofacial surgery 08/2012; 23(5):1404-6. · 0.81 Impact Factor
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ABSTRACT: To apply different types and concentrations of T&T olfactometer odorants to exam smell function and explore the clinical characteristics of partial olfactory dysfunction.
From March 2007 to May 2008, a total of 24 patients with olfactory dysfunction were examined by medical and psychiatric history enquiry, physical examination, smell testing and medical imaging. Olfactory function of each nostril was assessed separately by T&T olfactometer. The test contained five kinds of odorants at different concentrations. Recognition threshold (RT) scores for all five odorants and for each individual odorant were measured in all patients.
Among them, total RT scores were normal while single odorant testing yielded only significant higher RT scores for one or two odorants. For patients who suffered partial olfactory dysfunction, 51.4% are for pleasant odors, while the rest are for unpleasant odors.
Normal total RT scores and abnormal single RT scores of T&T olfactometer are present in partial olfactory dysfunction. As a special clinical manifestation of olfactory disorder, it may be easily ignored in smell testing.
Zhonghua yi xue za zhi 08/2012; 92(32):2274-6.
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ABSTRACT: Congenital skull defect is a rare malformation that is usually associated with congenital anomalies of the scalp and comparable lesions in the brain, spinal cord, limbs, and skeletal muscle. Most previously reported cases have described skull defects with aplasia cutis congenita and other congenital abnormalities. Very few patients with skull defects present with an intact scalp or neurofibroma. The authors report an adult patient with a rare congenital skull defect and local neurofibroma.
The Journal of craniofacial surgery 07/2012; 23(4):e275-6. · 0.81 Impact Factor
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ABSTRACT: To investigate the surgical therapy of midline skull defect accompanied with frontal sinus injury.
11 cases with midline skull defect accompanied with frontal sinus injury were treated. Free temporal fascia was transplanted to close the top of frontal sinus after curettage of the frontal sinus wall. Then titanium prostheses were used to repair the skull defects at the same stage in 10 patients. 1 patient received skull defect repair at the second stage operation.
Good results were achieved in 10 cases. The titanium prosthesis had to be taken out in one case due to frontal sinusitis and the anastomosis of frontal sinus and nasal cavity was performed.
In patients with midline skull defect accompanied with frontal sinus injury, free temporal fascia could be used to close the top of frontal sinus after curettage of frontal sinus wall. If there is no infection or mild infection in frontal sinus, the skull defect repair could be performed in the same stage. If there is severe frontal sinusitis, the defect repair should be done at the second stage.
Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery 03/2012; 28(2):105-9.
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ABSTRACT: To report a series of patients with isolated congenital anosmia and summarize their clinical and magnetic resonance imaging (MRI) characteristics.
Twenty patients with isolated congenital anosmia were reviewed retrospectively. A thorough medical and chemosensory history, physical examination, nasal endoscopy, T&T olfactory testing, olfactory event-related potentials, sinonasal computed tomography scan and magnetic resonance image of olfactory pathway were performed in all patients.
Neither ENT physical examination nor nasal endoscopy was remarkable. Subjective olfactory testing indicated all of them were of anosmia. No olfactory event-related potentials to maximal stimulus were obtained. Computed tomography scan was normal. MRI revealed the absence of olfactory bulbs and tracts in all cases. And hypoplasia or aplasia of olfactory sulcus was found in all cases. All the patients had normal sex hormone level.
The diagnosis of isolated congenital anosmia is established on chief complaints, physical examination, olfactory testing and olfactory imaging. MRI of olfactory pathway is indispensable.
Zhonghua yi xue za zhi 05/2010; 90(20):1424-6.
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ABSTRACT: To investigate the influence of mandibular curved osteotomy on masticatory function by analyzing the bite force before and after operation.
From Jan. to Oct. 2008, 20 female cases underwent mandibular curved osteotomy. The maximal bite force in incisor area, bilateral premolar area and molar area was measured before operation and 6 months after operation.
The maximal bite force in incisor area, right premolar area, left premolar area, right molar area, left molar area was (11.7 +/- 3.9) kg, (23.2 +/- 1.6) kg, (30.9 +/- 2.3) kg, (35.6 +/- 4.2) kg, (38.5 +/- 3.1) kg, respectively before operation; and was (11.9 +/- 2.1) kg, (23.0 +/- 4.5) kg (31.0 +/- 1.8) kg,(35.9 +/- 3. 5) kg. (38.5 +/- 2.7) kg, respectively 6 months after operation. The postoperative maximal bite force reached the preoperative level, and even slightly above it. There was no significant difference between the measured data before operation and 6 months afterward (P > 0.05).
The curved osteotomy of prominent mandibular angle has no long-term effect on masticatory function.
Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery 03/2010; 26(2):93-5.
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Jian Wang,
Hui You,
Zhen-Xin Zhang,
Jing Guan,
Xing-Ming Chen, Jian-Feng Liu,
Da-Hai Yang,
Ying-Ying Shang,
Ying-Ying Zhu,
Qi-Juan Zou,
Zhi-Qiang Gao,
Dao-Feng Ni
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ABSTRACT: To investigate the differences of olfactory bulb (OB) volumes between younger and older, male and female, left-side and right-side in healthy middle and old-aged persons by MRI.
Ninety five healthy middle and old-aged volunteers (male:female = 45:50) were divided into 2 groups, group one included persons aged from 50 to 69, group two included persons elder than 70. The left-side, right-side and both-side volumes of OB, the volumes of brain and the ratio of OB/brain were measured by MRI.
(1) The left-side and both-side volumes of OB (x(-) +/- s), the volumes of brain [(39.89 +/- 8.7) mm(3), (81.70 +/- 16.8) mm(3) and (1281.86 +/- 140.2) cm(3)] in 50 - 69 years old group were respectively larger than those in >/= 70 years old group [(34.45 +/- 10.4) mm(3), (72.10 +/- 19.3) mm(3) and (1165.77 +/- 165.3) cm(3)], and the differences reached statistical significance (t were respectively 2.649, 2.449, 3.516, all P < 0.05). There were no significant differences of right-side OB volumes and the ratio of OB/brain between 50 - 69 years old group and >/= 70 years old group (t were respectively 1.904, 0.616, each P > 0.05). (2) The male's OB volumes of left-side, right-side and both-side, the brain volumes and the ratio of OB/brain were respectively larger than females', and the differences reached statistical significance (t were respectively 4.461, 3.630, 4.399, 3.800, 2.400, all P < 0.05). (3) The right-side OB volumes were larger than left-side's and significant differences were found in female group, 50 - 60 years old group and >/= 70 years old group (t were respectively 2.732, 2.117, 3.516, all P < 0.05). There were no significant differences of OB volumes between left-side and right-side in female (t = 2.649, P = 0.110). The ratio of right-side OB/brain were larger than the ratio of left-side's and the differences reached statistical significance (t = 3.183, P = 0.002).
MRI could be used to measure the volume of OB. The older the people, the smaller the OB volumes. There was no influence of age on the ratio OB/brain. The OB volumes of right-side were larger than those of left-side. The OB volumes of male were larger than those of female.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 12/2009; 44(12):1006-9.
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ABSTRACT: To explore the feasibility of functional magnetic resonance imaging (fMRI) in analysis of olfaction function with modified OEP-98C olfactometer and event-related design.
Six young right-handed men underwent olfactory fMRI with event-related design. OEP-98C olfactometer was modified to accommodate MR environment. There were 2 types of tasks in the experiment. In one task, only isoamyl acetate was used as odorant. In the other task, to avoid possible decreased olfactory attention, vanillin was given before each presentation of isoamyl acetate.
In both tasks, uniform activation in piriform cortex and secondary olfactory cortexes was determined. The activation of piriform cortex was not significantly different between the two tasks (P > 0.01).
With isoamyl acetate as odorant, modified OEP-98C olfactometer, and event-related design, olfaction fMRI can depict cortex activation at primary and secondary olfactory cortex. Applying other odorant with similar quality to avoid olfactory attention decrease can not promote depiction of activation in primary olfactory cortex.
Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae 04/2009; 31(2):134-8.
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ABSTRACT: To explore the brain activation mapping following odor presentation with event -related functional magnetic resonance imaging.
Ten healthy young volunteers with normal sense of smell and 5 anosmia patients, all right-handed, underwent routine otorhinolaryngological examination and T&T subjective smelling test. Odorant isoamyl acetate was delivered by olfactometer synchronously with inspiration birhinally for 10 times with the interstimulus interval of 60 seconds. Functional magnetic resonance imaging (fMRI) based on the blood-oxygen-level dependent effect was carried out on a 3.0 T scanner, using gradient-recalled echo and echo-planar imaging technique, and the image data were analyzed with SPM2 software.
Functional activations were found in the volunteers with normal sense of smell, but not in the patients with anosmia. The activation regions were present in the orbitofrontal gyrus, anterior cingulate gyrus, piriform cortex, insular gyrus, amygdala, thalamus, basal nuclei, temporal gyrus, and frontal gyrus. There were more active regions in the right hemisphere than in the left hemisphere, and there were 314 and 57 active voxels in the right and left hemispheres respectively.
Olfactory event-related fMRI is an objective measurement of olfaction, and has potential clinical application value.
Zhonghua yi xue za zhi 06/2008; 88(22):1543-6.
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ABSTRACT: Using olfactory event related potentials (OERP) and magnetic resonance to evaluate olfactory function in patients with posttraumatic anosmia.
Twenty four patients with posttraumatic anosmia were reviewed retrospectively. A thorough medical history, physical examination, nasal endoscopy, T&T olfactory testing, olfactory event-related potentials, brain computed tomography scan and magnetic resonance image of olfactory pathway were performed in all patients.
Subjective olfactory testing indicated 20 of 24 patients were birhinal anosmia, 2 with right nostril anosmia and left impairment, 2 with left anosmia and right normal. No OERP were obtained in 24 (20 were birhinal, 4 was monorhinal), except 4 cases with single nostril. Magnetic resonance imaging revealed the injures to the olfactory bulbs (100%), rectus gyrus (91.7%), orbital gyrus (67%), olfactory tracts (8%) and temporal lobes (8%).
OERP can objectively evaluate posttraumatic olfactory function, and magnetic resonance of olfactory pathway can precisely identify the location and extent of injures.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 03/2008; 43(3):198-201.
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ABSTRACT: To report on a series of patients with congenital anosmia, and to discuss its classification and clinical characteristics.
Eight patients with congenital anosmia were reviewed retrospectively. Four of eight cases were congenital anosmia with other abnormalities, including three cases with Kallmann's syndrome, one with hypoplasia of nasal cavity and nasal sinus. Four cases were isolated congenital anosmia. A thorough medical and chemosensory history, physical examination, nasal endoscopy, T&T olfactory testing, olfactory event-related potentials and sinonasal computed tomography scan were performed in all patients. Magnetic resonance image of olfactory pathway was available in seven cases, and olfactory biopsies were done in two cases.
All patients reported had never been able to smell anything. ENT physical examination and nasal endoscopy were normal, except one case with hypoplasia of nasal cavity. Subjective olfactory test indicated all of them were anosmia. No olfactory event-related potentials to maximum stimulus were obtained. Magnetic resonance imaging revealed the absence of olfactory bulbs and tracts in six cases, hypoplasia of bilateral olfactory bulbs and tracts in one case. Computed tomography scan indicated normal except hypoplasia of nasal cavity and sinus in one case. Three cases with Kallmann syndrome showed poor development of both primary and secondary sexual characteristics and had decreased serum luteinizing hormone, follicle-stimulating hormone, testosterone and estradiol.
Diagnosis of congenital anosmia is established on chief complain, physical examination, nasal endoscopy, olfactory testing and olfactory imaging. Magnetic resonance imaging of olfactory pathway is indispensable.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 11/2007; 42(10):749-52.
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ABSTRACT: To report a new entity-olfactory cleft disease, and summarize the clinical characteristics, computerized tomography presentation, as well as the effect of trial therapy.
Three patients with chief complaint of anosmia were evaluated by thorough ENT examination, T&T olfactory testing, sinonasal endoscopy; sinonasal computerized tomography imaging, and olfactory event-related potentials. All patients accepted trial therapy including antibiotics and corticosteroid.
Complete obstruction of bilateral olfactory cleft with cleft mucosal edema was seen during endoscopy in all 3 patients. Anosmia was determined in all patients by T&T olfactory testing. No olfactory event-related potentials was identified in all patients. CT revealed soft tissue image limited to bilateral olfactory cleft. No olfactory improvement was found in 2 patients after trial medical therapy. One patient had transitory olfactory improvement after corticosteroid treatment.
Olfactory cleft disease is a new entity, with chief complaint of anosmia. Nasal endoscopy and computed tomography scanning provides the most information for the diagnosis. Effect of medical therapy is poor.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 04/2006; 41(4):274-5.
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Zhi-yong Zhang,
Lai Gui, Jian-feng Liu,
Li Teng,
Feng Niu,
Ji Jin,
Lu-ping Huang,
Bing Yu,
Dong Yu,
Xiao-jun Tang,
Zong-mei Zheng,
Yu-feng Liu
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ABSTRACT: To study the surgical reconstruction of unilateral Craniofacial Atrophy and Hypoplasia.
According to the etiological factors and severity of the facial deformities, different methods are employed, including bone framework reconstruction, soft tissue transplantation, orthognathic surgery.
From September 1998 to August 2004, 42 cases were treated, Include: Hemifacial Microsomia 22 cases, Hemifacial Atrophy 16 cases, unilateral facial hypoplasia due to radiation 4 cases. Miniplate and transplants extrusion occurred on 2 post radiation patients due to poor soft tissue coverage, infection occurred on 1 patient after mandibular ramus reconstruction using autogenous rib and contralateral mandibular outer cortex. The leaving patients recovered well and the facial asymmetry were improved greatly.
Facial asymmetry due to unilateral Craniofacial Atrophy or Hypoplasia is a common and complex condition for surgical management, The surgical plan should be delicated made individually according to the severity of the soft tissue and the underlying bone framework.
Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery 04/2006; 22(2):99-102.
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ABSTRACT: To investigate the causes and the prophylactic for the complications following mandibular distraction osteogenesis using internal distractors.
From 1997 to 2004, a total of 46 patients (61 sides) suffering from malformations or defects of mandible who underwent mandibular distraction osteogenesis were analyzed. The diseases included hemifacial microsomia in 27 cases, congenital or acquired mandibular hypoplasia and micrognathia bilateral in 8 cases and unilateral in 4 cases, electronical injury or postoperative mandibular defects in 3 cases, Treacher Collins syndrome in 2 cases, obstructive sleep apnea syndrome in 2 cases.
Of them, 9 patients had postoperative complications, which included 3 patients had complications associated with distractors, local infection occurred in 2 cases, apertognathia of anterior teeth in 2 case, 2 patients had sinus of the skin of the lower lip. 9 patients had been aggressivly managed and obtained satisfactory results.
The pivotal points to reduce complications are to understand the mechanism of mandibular distraction osteogenesis completely, and to be familiar with the anatomy of mandible and adjacent tissues. It is necessary to treat with it preoperatively and postoperatively.
Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery 02/2006; 22(1):18-21.
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ABSTRACT: To explore the surgical approaches to obtain good aesthetic and functional results in the management of orbital and periorbital fibrous dysplasia and related deformities.
Ten cases of orbital and periorbital fibrous dysplasia were treated surgically. The location, extension and shape of the lesions were identified based on X-ray examination and two and three dimensions CT examinations preoperatively. According to the type of the lesion, different approaches were used to excise the lesion and to reconstruct the orbit. The lesions were radically or partially excised through bicoronal, intraoral and subciliary approach; the orbit was reconstructed with autogenous outer or inner table of calvarium, outer table of mandible, Medpor and prefabricated individual titanic implants.
In 10 cases treated surgically, radical excision was employed in 4 cases and partial excision in 6 cases. Autogenous inner table of calvarium was used in 2 cases, Medpor in 2 cases, outer table of mandible in 1 case, and titanic meshwork and prefabricated individual titanic implants in 4 cases to reconstruct the orbit. After the treatment, all patients obtained satisfactory aesthetic and functional results.
Carefully planed surgical approaches with methods for preventing the complications can be used for the treatment of orbital and periorbital fibrous dysplasia and obtaining satisfactory aesthetic and functional results.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 01/2005; 40(12):800-3.
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ABSTRACT: To report on a series of patients with glomus tympanicum or glomus jugulare tumors, and to focus on its diagnosis, treatment, and outcomes.
Ten patients with glomus tympanicum or glomus jugulare tumors at Peking Union College Hospital during a 17-year period were reviewed retrospectively.
There were 7 patients with glomus tympanicum, 3 with glomus jugulare tumors, 1 patient with familial paraganglioma and 1 with functioning glomus jugulare tumors. The most common presenting symptoms were pulsatile tinnitus and hearing loss. Other symptoms included facial nerve paralysis, vertigo, otalgia, dysphagia, hoarseness, throat sore, episodic hypertension with headaches and tachycardia. The most common physical sign was a vascular middle ear mass. The other physical signs included Brown sign, upper neck mass, pharyngeal plump, Collet-Sicard syndrome, Homer's syndrome as well as deficit of cranial nerve V. The radiographic evaluation included computed tomograph (9 cases), angiography (4 cases) and magnetic resonance imaging (1 case). Eight patients initially refered to ENT department, and 2 patients initially consulted neurology or endocrinology specialists. The treatment included preoperative embolization in 2 cases, simple surgery in 4 cases and surgery followed by radiation therapy in 6 cases. No significant complications occurred. Nine of the 10 patients were followed up, but 1 was lost. The mean follow-up time was 12 years (ranged, 2-19 years). No tumor recurrence occured in the 6 cases with total tumor removal. Three cases with subtotal tumor resection had no tumor progression.
The diagnosis and treatment of glomus tympanicum and glomus jugulare tumors is particularly challenging. Typical clinical manifestations and radiographic evaluation should be considered together to establish the diagnosis. The primary treatment for glomus tympanicum is surgery, if necessary, followed by radiotherapy. Subtotal tumor resection followed by radiation yields satisfying outcome for glomus jugulare tumors.
Zhonghua er bi yan hou ke za zhi 10/2004; 39(9):543-5.
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ABSTRACT: This study aimed to explore the changes in the masseter muscle after curved osteotomy of the prominent mandibular angle and to supply guidance for resection of the mandibular angle.
Ultrasonography was used to assess changes in the thickness of the masseter muscle after curved osteotomy for 10 patients (20 hemimandibles) at the 6-month following-up assessment. The measurements were performed under both relaxing and maximal clenching positions through three cross sections of the masseter muscle (planes A, B, and C). Plane A contains the line from the mouth angle to the ipsilateral ear lobe. Planes B and C are parallel planes above and below plane A with a distance of 1 cm between them.
No significant difference between the preoperative and postoperative thicknesses of the masseter muscle for planes A and B (p > 0.05) was found, but there was a significant difference (p < 0.05) for plane C. The postoperative thickness of the masseter muscle in plane C was reduced by 0.244 +/- 0.121 cm in the relaxing position and by 0.244 +/- 0.142 cm in the clenching position, which were respectively 19.22% +/- 7.785% and 15.404% +/- 7.648% of its original thickness. There was no significant difference in the contraction amplitude of the masseter muscle under maximal clenching (p > 0.05) for any of the three cross sections postoperatively.
The masseter muscle around the mandibular angle becomes atrophied but without functional defect after curved osteotomy. Patients with prominent mandibular angles can be treated simply with curved osteotomy instead of masseter excision.
Aesthetic Plastic Surgery 31(6):732-8. · 1.41 Impact Factor
