Treatment of laryngeal granuloma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study treatment method of laryngeal nonspecific granuloma.@*METHOD@#Twenty-five patients with histopathologically identified laryngeal nonspecific granuloma were retrospective reviewed from 1998-2005. All patients were surgically treated by laser laryngomicrosurgery under general anesthesia, postoperative non-operative therapies included anti-gastroesophageal reflux medication, topical inhalant steroid (Beclometasone, Fluticasone) and voice therapy. Two patients were treated with 12 Gy of low-dose radiotherapy after surgery.@*RESULT@#Laryngeal nonspecific granuloma have remarkable tendency of recurrence despite of surgery and non-surgical managements. Recurrence of laryngeal nonspecific granuloma occurs between 2-3 months postoperatively and requires repeated operation for 3 5 times. For intubation granuloma, 6 out of 8 were healed. Six out of eight contact granulomas were healed. Six of gastroesophageal reflux granulomas were healed. Glottic carcinoma was demonstrated in one case after 2 sessions of combined managements. Two patients were completely healed by low-dose radiotherapy of 12 Gy.@*CONCLUSION@#Laryngeal nonspecific granuloma have an obvious tendency of recurrence, however, surgery is an important therapy. Combined non-surgical therapies (anti-gastroesophageal reflux medication, topical inhalant steroid and voice therapy) are necessary. In case which routine ways fail to control recurrence, low-dose radiotherapy is recommended because of its safety and satisfied effect.

Study on susceptibility test of pathogenic fungi from otorhinolaryngology by Etest method / 临床耳鼻咽喉头颈外科杂志

Objective:To study the sensitivity of pathogenic fungi from otorhinolaryngology to 5 antifungal agents of Ketoconazole(KE), Itraconazole(IT),Fluorocytosine(FC),Amphtericin B (AP) and Fluconazole(FL) by Etest method.Method:Etest for determine MIC of 14 pathogenic fungi was performed according to the manufactuer′s instructions.The Etest strip containing the 5 antifungal drugs were putted on medium with Candida albicans,A.flarus and A.fumigatus etc,respectively,to determine MIC of antifungal drugs.Result:Candida albicans were sensitized to all the above 5 antifungal drugs, KE and IT were most sensitized.Seven fungi such as A. flavus, A fumigatus, A.oryzae etc were all sensitized to KE and IT.The MIC range of KE and IT against 15 strains of pathogenic fungi were≤0.008～2 mg/L and ≤ 0.006～4 mg/L respectively.In 15 strains,11 strains showed drug-resistant to FL,8 strains to AP and FC,4 strains to KE and 1 strains to IT respectively and MIC were all >32 mg/L.Conclusion:Etest MIC were in good agreement with macrobroth MIC.The use of Etest strips for antifungial susceptibility test is a new and promising method with advantage of easy to perform, exact results and satisfactory reproducibility. Etest is valuable on clinical practice.