Modified intratympanic steroid therapy for sudden sensorineural hearing loss via tympanic tube and gelfoam as a salvage treatment

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.

心心相印——心脏CT

心脏冠状动脉CT(心脏CT)检查是将碘造影剂注射入血管进行造影的医学检查技术,心血管内科医生可根据影像对心脏冠状动脉的堵塞和血流速度作出诊断。检查之前,患者需保持稳定的心率,一般要求每分钟不高于60次,如心率过快可利用β-受体阻滞剂、硝酸甘油等药物进行降低。此技术检查时间短、副作用小、漏检率和误检率很低。

助力火箭,推动梦想——神秘的助推剂

生存在古丝绸之路上河西走廊的朱雀家族成立了蓝箭基地,一直在探索环保、经济和安全的助推剂。小朱雀来参观,了解了多种液体推进剂,有推力巨大但容易积碳的液氧煤油、环保但耗能的液氧液氢、稳定但有毒性的偏二甲肼和四氧化二氮,最后他们了解到由蓝箭基地发射的朱雀二号运载火箭是全球首枚以液氧甲烷为推进剂的火箭。甲烷有丰富的储量、温和的储存条件和运输安全性、燃烧充分而且产物无污染,在未来有更广阔的用途。

Molecular mechanisms and roles of inflammatory responses on low-frequency residual hearing after cochlear implantation

Preservation of low-frequency residual hearing is very important for combined electro-acoustic stimulation after cochlear implantation.However,in clinical practice,loss of low-frequency residual hearing often occurs after cochlear implantation and its mechanisms remain unclear.Factors affecting lowfrequency residual hearing after cochlear implantation are one of the hot spots in current research.Inflammation induced by injury associated with cochlear implantation is deemed to be significant,as it may give rise to low-frequency residual hearing loss by interfering with the blood labyrinth barrier and neural synapses.Pathological changes along the pathway for low-frequency auditory signals transmission may include latent factors such as damage to neuroepithelial structures,synapses,stria vascularis and other ultrastructures.In this review,current research on mechanisms of low-frequency residual hearing loss after cochlear implantation and possible roles of inflammatory responses are summarized.

Regulating photothermal properties of near-infrared croconaine dyes by supramolecular assembly

The photochemical and photophysical properties of near-infrared(NIR)dyes are significantly influenced by their aggregation state and mesoscopic morphology.However,beyond chemical synthesis,the regulation mechanisms for the properties of NIR dyes,particularly with respect to photothermal properties of the aggregates,are not yet fully understood.Here,we investigate the photothermal behaviors of croconaine-based(CroA)NIR dyes containing dipeptide or amino acids moieties.The introduction of hydrogen bonding promotesπ-πstacking of croconaine center,which can efficiently regulate aggregation states and assembly structures in isopropanol.Under laser irradiation,CroA aggregates undergo aggregation-dissociation transition,the in-situ monomer generation process regulates two parameters of photothermal performance:heating rates and plateau photothermal temperatures.This study reveals the regulation effect of non-covalent bonding interactions on CroA aggregates,highlighting supramolecular assembly strategy not only facilitates to construct of photothermal nanomaterials with well-defined structures,but also provides an alternative and effective method for regulating photothermal performance of NIR dyes.

Post-operative venous thromboembolism in patients after extracranial otologic surgery: A case series

Objective:This study aimed to report 9 venous thromboembolism(VTE)cases after extracranial otologic surgery and analyze the potential risk factors.Study design:Case series.Setting:Single tertiary-level academic center.Methods:Totally,9 cases of VTE were identified among adults who underwent extracranial otologic surgery at our hospital from January 2018 to December 2020.Caprini risk scores were calculated,and comprehensive preoperative,operative,and postoperative clinical data within 14 days were collected to assess the evidence of VTE.Results:The median age of 9 patients was 64 years old.Among them,7(77.8%)patients presented with intramuscular vein thrombosis,1(11.1%)patient had deep vein thrombosis,and 1(11.1%)patient experienced pulmonary embolism.Preoperatively,8(88.9%)patients had low or middle Caprini risk scores(≤4)with an average of 2.67±0.47 points.The average Caprini scores for all patients were 4.44±0.35 on postoperative day(POD)1 and 5.67±0.64 on POD14.D-dimer levels were collected,indicating an average of 0.55±0.17 mg/FEU preoperatively,8.53±3.94 mg/FEU at day 1,and 3.76±0.45 mg/FEU at POD14.In postoperative period,7(77.8%)patients experienced vertigo/dizziness and/or head immobility/bed rest.Conclusion:The present study highlighted that patients with low-and middle-risk of VTE undergoing otologic surgery should be also vigilant about postoperative VTE.Vertigo/dizziness and/or head immobility/bed rest in postoperative period should be considered as minor risk factors for developing VTE in patients undergoing extracranial otologic surgery.Conducting perioperative assessments,including Caprini risk score evaluation,Ddimer testing,and venous ultrasound of lower extremities,is recommended to ensure patients’safety.