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ABSTRACT: To find out the clinical characteristics of Meniere's disease in flight aircrew and discuss relevant principles of clinical aviation medicine, in order to summarize experience in medical evaluation of aircrew.
Collect the data of 35 cases that were diagnosed with Meniere's disease from 1966 to 2011 in our hospital and analyze the clinical characteristics, diagnosis and flight conclusion of them.
Among the 35 cases, 34 patients complained of vertigo. 27 patients complained of tinnitus and 21 patients complained of hearing loss. (1) 18 cases manifested typical symptoms of Meniere's disease (paroxysmal vertigo, fluctuating neurosensory hearing loss, tinnitus and ear fullness); (2) 7 patients showed the symptoms of vertigo and tinnitus, not complaining of significant hearing loss (after inspection. 4 of them proved the low-frequency hearing loss); (3) 7 patients only manifested as vertigo; (4) 2 patients manifested as tinnitus and hearing loss. 1 patients manifested only hearing loss. On the basis of the diagnostic criteria of Meniere's disease formulated hy Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery. 22 patients were diagnosed with definite Meniere's disease, 2 patients were diagnosed with probable Meniere's disease, 11 patients were diagnosed with possible Meniere's disease. For patients with definite Meniere's disease and probable Meniere's disease, the phases of the disease were: 11 cases of phase I, 7 cased of phase II and 6 cased of phase III. The flight conclusion of all the 35 patients was permanent grounding. The time from the attack of the disease to receiving the conclusion of permanent grounding fluctuated from three months to 11 years.
The diagnosis of Meniere's disease of flight aircrew must he cautious. For patients with atypical symptoms of Meniere's disease, the diagnosis should be made in the case of completely ruling out other possible diseases. Once be diagnosed, a patient should normally be flight unqualified. The flying waiver would he recommended only under exceptional circumstances. The criterion of waiver condition need to be further explored in the future.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 01/2013; 27(1):16-9.
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ABSTRACT: To comparatively analyze the disease data of nasal sinus between helicopter and (strike) fighter pilots under flying qualification, and then to provide references for aeromedical support as a significant part of new logistics service union in army,
The CT data of nasal sinus in 138 pilots who accepted physical examination for change to new-type aircraft, were collected included 46 cases of helicopter pilots and 92 cases of (strike)fighter pilots). The incidence of chronic sinusitis and cyst of nasal sinus were computed respectively in helicopter pilots and (strike)fighter pilots.
(1) Fourteen cases suffered from chronic sinusitis (6 cases of maxillary sinusitis, 4 cases of ethmoiditis and 4 cases of maxillary sinusitis and ethmoiditis) in helicopter pilots whose incidence rate of chronic sinusitis was 30.4% (14/46). Of which, 3 cases of antracele were treated. Twelve cases suffered from chronic sinusitis (8 cases of maxillary sinusitis, 1 case of ethmoiditis, 3 cases of maxillary sinusitis and ethmoiditis) in (strike)fighter pilots whose incidence of chronic sinusitis was 13.0% (12/92). Of which, 1 case of antracele was treated. The incidence of chronic sinusitis was higher in helicopter pilots than (strike) fighters pilots (Chi2 = 6.07, P < 0.05). (2) Four cases suffered from unilateral mucosa cysts in maxillary sinus in helicopter pilots whose incidence of cyst of nasal sinus was 8.7% (4/46). Ten cases suffered from mucosa cysts in maxillary sinus (unilateral 8 cases and bilateral 2 cases) in (strike) fighters pilots whose incidence of cyst of nasal sinus was 10.87% (10/92). The difference of the incidence of cyst of nasal sinus was not statistically significant between the helicopter pilots and(strike)fighters pilots. The cysts of nasal sinus did not need treatment in 14 cases of this group data.
The incidence of symptomless chronic sinusitis and cyst of nasal sinus are high in pilots. It is related with repeatedly changes of atmosphere pressure during flying. But most chronic sinusitis and cyst of nasal sinus do not need treatment. The incidence of chronic sinusitis is higher in helicopter pilots than(strike)fighter pilots. It may be related with the environment of helicopter which have unclosed cockpit and load other aircrew.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 01/2012; 26(2):62-4.
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ABSTRACT: We investigated whether early atherosclerosis before calcified plaque appeared as assessed by carotid intima-media thickness (IMT) was associated with levels of the major carotenoids, and assessed the associations among these serum carotenoids, carotid IMT, and arterial stiffness.
The case-control study comprised 125 subjects with early atherosclerosis and 107 controls aged 45-68 years. We simultaneously measured common carotid IMT and arterial stiffness by carotid ultrasonography, and serum carotenoids were determined by high-pressure liquid chromatograph (HPLC).
In cases of early atherosclerosis, serum level of lutein was significantly lower than that in controls. Serum lutein was inversely associated with carotid IMT. Zeaxanthin and β-carotene were both negatively correlated with right common carotid artery stiffness β, elastic modulus (E(p)), and pulse wave velocity (PWV). After adjusting for age and gender, the associations remain significantly (P<0.05). However, there is no significant difference for zeaxanthin and β-carotene between the cases and controls.
These findings suggest that lutein may play a protective role in the prevention of early atherosclerosis, and the associations between serum carotenoids and arterial stiffness remained to be investigated.
Atherosclerosis 08/2011; 219(2):789-93. · 3.79 Impact Factor
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ABSTRACT: To sum up the experiences of diagnosis, treatment and medical evaluation of head and neck tumors in aircrew.
Sixty-seven cases of pilot patients with head and neck tumors in our hospital since September in 1979 to July in 2009 were retrospective analyzed in the study.
Among 44 aircrew with benign head and neck tumors there were 37 cases continued their flying jobs and 7 cases were permanently grounded; whereas in 23 aircrew with malignant tumors there were 6 cases qualified for flight and 17 patients unqualified.
Benign or malignant of the head and neck neoplasm in the pilots are not the exclusive basis for their medical assessment. Tumor nature, location, efficacy of treatment and the impact on the function of their body should be considered as making the flight medical evaluation for the aircrew with head and neck tumors. Early diagnosis and treatment of head and neck tumors in aircrew are very important for reducing the rate of grounded.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 03/2011; 25(5):223-5.
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ABSTRACT: To explore the possible mechanisms of the protective effect of lutein against retinal damage induced by blue-light.
Ninety six female SD rats (8 week-old, 200 g) were divided into six groups: normal control (NC), blue light injury (MC), blue light + solvent (SC), blue light + 0.5 mg/ml lutein (L0.5), blue light + 1.0 mg/ml lutein (L1.0) and blue light + 2.0 mg/ml lutein (L2.0). The content of malondialdehyde (MDA) and the activities of peroxide dismutase (SOD) and glutathione peroxidase (GSH-Px) of retina were measured as oxidative stress markers. Neuron nitricoxide synthase and the expression of c-fos protein in retina were analyzed by Western Blot.
The content of MDA increased in the retina induced by photic injury, and the increase was protected significantly by lutein treatment (P < 0.05), but no dose-dependent response of lutein on the activities of SOD and GSH-Px was observed (P > 0.05). The expression of c-fos protein was significantly higher in the retina of MC and SC group than that in lutein-treated groups (P < 0.05), while the expression of nNOS was not significant different between groups.
The mechanisms of lutein protecting retina from blue-light damage might be quenching singlet oxygen, inhibiting lipid peroxidation and c-fos gene expression.
Wei sheng yan jiu = Journal of hygiene research 11/2010; 39(6):689-92.
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ABSTRACT: To conclude the correlation between the alternatives of anesthesia--general and local anesthesia--and the complications of nasal endoscopic surgeries.
Summing up the occurrence rates of the complications from 176 cases (321 sides) of patients with sinusitis(some were air crew); comparing and calculating these complications according to the ways of anesthesia which were adopted in the surgeries.
The occurrence rates of the complications from nasal endoscopic surgeries were 6.9% (22/321) and rates of major complications were 1.6% (5/321). Rates of 1.9% (4/210) occurred after surgeries with local anesthesia, 16.2% (18/111) with general anesthesia, which indicated the striking differences between them (chi2 = 21.11, P < 0.01). There were no differences between the types of diseases resulted from the choice of anesthesia (Type I and Type II, Type I and Type II, Type II and Type III chi2 = 0.06, 2.56, 3.82; P > 0.05). However, the incidences of various types of complications with local anesthesia were less than those with general anesthesia, which differed significantly within two groups (P < 0.05). No cases of obvious complications occurred to air crew.
The occurrence rates of complications of endoscopic surgeries with local anesthesia are lower than that of those with general anesthesia, which is worth promoting in ground crew and sing for reference to elevate rate of resuming flight in aircrew.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 04/2010; 24(8):356-8.
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ABSTRACT: To evaluate the therapeutical effects of diplopore puncture of tympanum and intratympanic administration (DPTIA) on patients with acute secretory otitis media (ASOM).
One hundred and forty-one cases with ASOM were divided into two groups randomly, with 69 cases (80 ears) in group A (experimental group) and 72 cases (84 ears) in group B (control group). Group A was treated with DPTIA combined with medication, group B was treated with haplopore puncture of tympanum combined with medication. All patients accepted 1 to 3 courses of treatment, and were observed during the period of treatment and 3 months after treatment.
The factors (including gender, age, side of ailing ear, course of disease, air-bone gap in the pure tone average, and acoustic immittance type in ailing ear) which may impact the prognosis were matched in two groups prior treatment (P>0.05). While there was a significant difference in the cure rate and the total effective rate respectively between two groups after treatment (P<0.05). No adverse reaction or complication was seen.
DPTIA is a safe, reliable and effective way to manage patients with ASOM.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 01/2010; 24(1):16-8.
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ABSTRACT: To sum up the experiences of diagnosis, treatment and medical evaluation of sinusitis and nasal polyp in aircrew.
Ninety three aircrew with sinusitis and nasal polyp were included in the study.
There were 11 cases with acute sinusitis and 82 cases with chronic sinusitis and nasal polyp. Of the 82 cases, there were 46 cases in class I (including 39 cases with symptoms and signs on ground in Ia, 7 cases only with signs in Ib), 36 cases in class II (no symptoms on ground but with symptoms of secondary barotraumas in flight, including 14 cases with secondary barosinusitis in IIa, 13 cases with secondary barotrauma in IIb, 9 cases with secondary barosinusitis and barotrauma in IIc ). Of the 82 cases, there were 24 cases in 1 stage of type I, 38 cases in 2 stage of type I, 7 cases in 3 stage of type I, 2 cases in 1 stage of type II, 6 cases in 2 stage of type II, 3 cases in 3 stage of type II, 2 cases in type III. Eighty four cases continued their flying jobs and 9 cases were permanently grounded.
Flying safe can be endangered by sinusitis and nasal polyp alone or with its secondary barotraumas. Chronic sinusitis and nasal polyp complicated with barotraumas are important causation for medical grounding. The aircrew with sinusitis and nasal polyp will be allowed to continue their flying jobs only after getting well curative effect and normal gas pressures of ear and nasal sinus.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 04/2009; 23(5):194-6, 200.
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ABSTRACT: To establish the animal model of aero-otitis media.
Thirty healthy guinea-pigs were selected and PVC tube was placed from left nasal cavity to nasopharynx for 7 days. Hypobaric chamber experiment was performed before and after tube placement, and also after the treatment. Eardrum examination and tympanogram were carried out each time before and after the hypobaric chamber experiment.
(1)The inflammation of nasal cavity, nasal sinuses and nasopharynx could be seen on CT after PVC tube placement. After treatment, the inflammation subsidised. (2) There was significant difference in left eardrum and tympanogram before and after tube placement, as well as after tube placement and after treatment. Significant difference could also be seen between left ear and right ear after the tube placement.
The animal model in this study may provide reference in diagnosis, classification, treatment and health evaluation of earo-otitis media in pilots.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 12/2006; 20(22):1032-4.
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ABSTRACT: To standardize conception, diagnosis methods and identification principles of fatal flight illusion in pilots.
Data of fatal flight illusion in 25 pilots were summed up.
(1) There were higher appearance ratios of inclination illusion, vestibular-proprioceptive illusion, type II spatial disorientation, and physiological-psychological illusion in fatal flight illusion of pilots. (2) Class A aircraft accidents happened in three pilots. Thirteen pilots were permanently grounded. Nine pilots were permitted to return their flying stations.
The fatal flight illusion is an important cause leading to permanent grounding and endangered flying safety. This study may be referred in the succedent study on dealing with fatal flight illusion in pilots.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 09/2006; 20(16):746-9.
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ABSTRACT: To comprehend the changes of disease spectrum of otorhinolaryngology in pilots of fighters.
It was analysed that disease spectrum of otorhinolaryngology in 230 pilots of three generation fighter, named as F5, F6 and F7.
(1) The top 10 diagnosis in disease spectrum were aortitis media, vertigo, noise-induced deafness, aero-sinusitis, illusion in flight, air-sickness, allergic rhinitis, vestibular dysfunction, chronic rhinitis and Meniere disease. (2) The top 10 diagnosis of F7 pilots changed obviously comparing with those of F5 and F6 pilots.
The disease spectrum of otorhinolaryngology of pilots is different in three generation fighters. Compared with F5 and F6 pilots, the proportion of some diseases in F7 pilots shows a trend of decrease, and some others shows a trend of increase. Analysis on the reasons for this change may improve the quality of asiatic medical service.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 02/2006; 20(1):13-5.
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ABSTRACT: To observe the characteristics of illusion in flight in fighter pilots.
A survey about illusion in flight was performed in 81 pilots who were under physical examination for modification to equipment of high performance aircraft.
1. Among 81 pilots, there were history of illusion in flight in 91.4% (74/81) cases. There were history of inclination illusion in 74 cases, rotation illusion in 1 case, inversion illusion in 1 case and pitch illusion in 1 case. 2. Among the 74 cases, 85.1% (63/74) claim relations with flying subjects, 81.1% (60/74) with distribution of attention, 74.3% (55/74) with light, 73.0% (54/74) with distribution of cloud layer, 71.6% (53/74) with visibility, 67.6%(50/74) with fatigue, 54.1% (40/74) with suspension of flying and 2.7%(2/74) with other factors. When illusion in flight appeared, 70 cases could easily overcome it, 4 cases felt a little difficult, but all 74 cases did not lead aircraft accident or potential accident.
Instructions in health about illusion in flight have made a considerably positive achievement in airman troops, but it must be continually paid more attention, and meanwhile, the space orientation system of aircraft must be improved.
Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 02/2004; 18(1):6-7.
