ObjectiveTo explore the reasonable path of caloric test in videonystagmography examination. MethodsPatients who received the videonystagmography examination in Xi'an Central Hospital were retrospectively analyzed. Using caloric test as standard, sensitivity, false negative rate, specificity and false positive rate of single temperature test were calculated and compared. Data was analyzed using SPSS 13.0 software. ResultsA total of 263 patients were included. In all subjects, the sensitivity of single hot test was 81.7%, which was higher than single cold one. The false negative rate was 18.3%, which was lower than single cold one. There were significant differences in the rate between both methods (P < 0.05). In patients accompanied with spontaneous nystagmus, the sensitivity of single hot test was 90.8%, which was the highest; the false negative rate was 9.2%, which was the lowest. There were significant differences in the rate between both methods (P < 0.05). ConclusionCold or warm water (gas) perfusion could be conducted in the reasonable path of caloric test as follows: heat stimulation of the affected side, heat stimulation of the normal side, cold stimulation of the affected side, and cold stimulation of the normal side. If the patients are unable to tolerate caloric test, the results of single hot test could be used as reference.
ObjectiveTo evaluate the initial results of hybrid procedure without sternotomy for aortic arch dissection, and also report our initial experience in performing this procedure. MethodsFrom January 2011 to September 2014, 17 patients diagnosed with aortic arch dissection by CT angiography undergoing the hybrid procedure (thoracic endovascular aortic repair combined with supra-arch branch vessel bypass) in the department of Thoracic Cardiovascular Surgery, Wuhan General Hospital of Guangzhou Command. There were 12 males and 5 females aged from 46 to 71 years. Their clinical data, including the imaging findings, treatment, and prognosis were retrospectively analyzed. ResultsLeft common carotid artery (LCCA) to left subclavian artery (LSA) bypass (n=4), right common carotid artery (RCCA) to LCCA to LSA bypass (n=3), RCCA to LCCA bypass merger covered LSA (n=3) were performed. All operations were successful. Laryngeal recurrent nerve injury occurred in one patient. All patients were followed up on the postoperative day 7, 30 and one year. All patients were followed up for 12 to 53 months till September 2015. There was no death, and no complications such as endoleak after the hybrid procedure, stenosis or blockage of the bypass graft during the follow-up period. ConclusionInitial results suggest that the hybrid procedure without sternotomy is a suitable therapeutic option for high risk aortic arch dissection patients in poor general condition with little tolerance to aortic arch replacement．