Clinical analysis of revision endoscopic sinus surgery for recurrent chronic rhinosinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the therapeutic effect of revision endoscopic sinus surgery for recurrent chronic rhinosinusitis.@*METHOD@#Clinical data of 45 cases of recurrent rhinosinusitis treated in our hospital were retrospectively analyzed. Revision endoscopic sinus surgery was performed in all the patients.@*RESULT@#All the patients were followed up for a period of 1 to 2 years after operation. No serious complication occured. The cure rate was 75.6% (34 cases), 8 cases (17.8%) improved, while other 3 cases (6.6%) were of no effect.@*CONCLUSION@#Recurrent rhinosinusitis is closely related with medical treatment before the surgery, adhesion in nasal cavity after the surgery, deviation of nasal septum, treatment of superior turbine and inferior turbine and regular medicament management after the surgery. Revision endoscopic sinus surgery is an effective method for recurrent recurrent rhinosinusitis. The efficacy of revision endoscopic sinus surgery can be greatly improved by reasonable perioperative management, skilled operation and regular follow-up postoperatively.

Clinical analysis of imflammatory myofibroblastic tumor of the nasal cavity and paranasal sinus / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical features, therapeutic methods and therapeutic efficacy of imflammatory myofibroblastic tumor(IMT)of the nasal cavity and paranasal sinuses.@*METHOD@#Clinical data of 14 cases diagnosed as IMT by pathology were retrospectively analyzed. There were 8 males and 6 females,age ranging from 18 to 77 years. 12 cases of them were treated by surgery while 2 cases received postoperative radiotherapy.@*RESULT@#All cases were operated. All the patients were followed up for a period of 1 to 7 years after operation and two cases were proved low grade IMT pathologically. Eight cases survived with no recurrence until the last follow-up and 6 cases relapsed, of which 4 cases died and 2 were alive with tumor.@*CONCLUSION@#IMT of the nasal cavity and paranasal sinuses is very rare. The diagonosis of IMT is based on pathology and immunohistochemistry. Proper diagnosis is essential to avoid mutilating and disfiguring surgical procedures. Radical excision is still the first choice of treatment for IMT of the nasal cavity and paranasal sinuses. Chemotherapy and radiotherapy may not be helpful to prevent recurrence after operation. Due to high recurrence rate, long-term follow up is necessary after operation.

Clinical analysis of endoscopic sinus surgery on patients with chronic sinusitis with nasal polyps complicated and asthma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the efficacy of the treatment of endoscopic sinus surgery on patients dignosed as chronic sinusitis with nasal polyps(CRSwNP) complicated and asthma.@*METHOD@#Data of 45 patients with CRSwNP complicated asthma were analyzed retrospectively.@*RESULT@#All cases were followed up for a period of 1 to 3 years after operation. In the 45 cases treated with ESS, 32 cases were cured, 9 cases were improved and 4 cases were inefficient by the treatment. The cure rate was 91.1% (41/45). The asthma symptoms were improved in 16 patients compared to 4 before the surgery.@*CONCLUSION@#With ESS based on combined therapy,it can significantly improve the condition of CRSwNP, asthma symptoms and pulmonary function. Meanwhile, sufficient perioperative period preparation should be made to ensure the safety of the operation.

Efficacy of CO2 laser in the treatment of precancerous laryngeal lesions under phonomicrosurgery and its relative factors / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the efficacy of CO2 laser treatment for patients with precancerous laryngeal lesions under phonomicrosurgery and to explore the points for attention in operation.@*METHOD@#They were all treated with phonomicrosurgery techniques as mucosal epitheliumablation or mucosal stripping by using CO2 laser. Eight patients with laryngeal papilloma were excised by CO2 laser.@*RESULT@#All patients were treated with CO2 laser surgery successfully. During follow-up of 6 to 39 months, all patients survived. Local recurrence or canceration were detected in 3 cases, of which 2 cases with laryngeal papilloma underwent CO2 laser treatment in one year post-operatively, while the other case with severe dysplasia underwent laryngeal vertical partial laryngectomy and post-operative radiotherapy one and half year postoperatively due to canceration. No local recurrence occurred until the last follow up. No severe complications such as dyspnea and hemorrhage occured.@*CONCLUSION@#CO2 laser surgery is an effective and minimally invasive treatment for precancerous laryngeal lesions. Through selecting the appropriate patient and paying attention to the operation during surgery, the adhesion of vocal cord can be reduced or even be avoided after CO2 laser surgery.

Endoscopic resection of benign fibro-osseous lesions of naso-sinuses with different surgical choice / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore and discuss the characteristics of benign fibro-osseous lesion of naso-sinuses and the features and indications of different surgical choice with endoscope.@*METHOD@#Fourteen patients with benign fibro-osseous lesion of naso-sinuses were treated through endoscopic surgery, of which 9 cases underwent endonasal endoscopic surgery simply, 2 cases were operated with a superciliary arch incision through endoscope, 1 case underwent endoscopic caldwell-luc' surgery, 1 case was operated with endoscopic surgery through frontal recess of tears, and 1 case was operated with Draf II surgery under endoscope.@*RESULT@#In all of patients, 2 cases relapsed, 2 cases had residual lesions, 4 cases had complications including numbness and scar of incision, no relapse and no complications in other 6 cases.@*CONCLUSION@#Endoscopic resection of benign fibro-osseous lesion of naso-sinuses with different surgical choice was of special advantages, but the exactly indications, relapse rate and complications should be observed and reckoned deeply.

Clinopahological analysis of sinonasal mucosal malignant melanoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinopathological characteristics, differential diagnosis, therapy and prognosis of sinonasal mucosal malignant melanoma.@*METHOD@#Clinopathological data of 18 cases which were diagnosed by pathology and immmunohistochemistry were analyzed retrospectively. All cases were proved by pathology and immmunohistochemistry. All cases were performed operations. 5 underwent single surgery. 4 underwent surgery plus adjuvant radiotherapy. 4 underwent surgery plus adjuvant radiotherapy chemotherapy. 5 underwent surgery plus adjuvant chemoradiation.@*RESULT@#All cases were followed up for a period of 1 to 7 years after operation. Twelve patients died of tumor until the last follow-up, meanwhile 6 patients stayed alive. In Six cases recurrence occurred. In five casescervical lymph node metastasis occurred, of which 3 cases received neck dissection and 2 cases received chemotherapy and radiotherapy due to no surgical indications. In three cases distant metastasis oc- curred.@*CONCLUSION@#Sinonasal mucosal malignant melanoma is rare and highly heterogenous. Current diagnosis depends on clinical characteristics and immunohistochemical examination. It still should be differentially diagnosed from other tumors. CT and MRI image examination can provide some helpful information to understand the extent and nature of lesions. The treatment of nasal endoscopic or the surgery under endoscopy has become to be a safe, viable and reasonable alternative to open resection. Appropriate indication must be carefully selected for these lesions.

Clinical analysis of endoscopic nasal cavity expansion surgery for treatment of obstructive sleep apnea hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the efficacy of endoscopic nasal cavity expansion surgery on obstructive sleep apnea hypopnea syndrome (OSAHS) and nasal obstruction.@*METHOD@#Clinical data of 48 OSAHS patients with structural abnormality in nasal cavity treated in our department were retrospectively analysed. These patients received endoscopic nasal cavity expansion surgery and were observed for the relief of both subjective and objective symptoms.@*RESULT@#PSG was reexamined 12 months postoperatively. Of all the patients, 29 cases (60.4%) showed complete recovery, 10 cases (20.8%) showed remarkable improvement of the symptoms, 4 cases (8.3%) exhibited curative effect and 5 cases (10.4%) were of no effect, respectively. The symptoms of apnea, hypopnea, LSaO2 and somnolence were significantly improved in all patients,and nasal congestion was obviously relieved. The improvement of snore was not evident.@*CONCLUSION@#Endoscopic nasal cavity expansion surgery is effective and safe for the treatment of OSAHS mainly due to nasal obstruction. Operation should be performed to correct structural abnormality in nasal cavity and adjust symmetric distribution of nasal airflow on both sides in order to maintain normal ventilation function. The procedure is applicable to OSAHS patients accompanied by nasal congestion and upper airway resistance syndrome and personalized adjustment is beneficial for better clinical efficacy according to the condition of different patients.

Clinical analysis of esophageal perforation and neck abscess induced by esophageal foreign body / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the diagnosis and treatment of esophageal perforation and neck abscess induced by esophageal foreign body and to make a better solution for the disease.@*METHOD@#Twenty-four cases with esophageal perforation and neck abscess induced by esophageal foreign body treated in our department were surgery under general anesthesia. The foreign bodies were removed via esophagoscope in 14 cases, thorocomy in 3 eral neck incision in 5; and no foreign bodies were found in 2 cases.@*RESULT@#There were 16 cases complicated by abscess. Among these complications,there were 10 cases of periesophageal abscess,4 cases of neck abscess and 1 case of mediastinal abscess. In 24 patients, 21 cases cured and one died. One case was sent to the department of endocrinology because of hyperglycaemia and two cases were sent to the department of thoracic surgery for further treatment.@*CONCLUSION@#Early diagnosis and treatment is the key to the management of esophageal perforation induced by esophageal foreign body. Thin-section CT has a high value for the diagnosis and differential diagnosis in such patients. Once deep neck abscess is diagnosed, an early abscess surgical drainage, an appropriate antibiotics and a nutrition supporting treatment are effective for the patients.

Clinical analysis of sinonasal hemangiopericytoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical features, therapeutic methods and therapeutic effects of sinonasal hemangiopericytoma.</p><p><b>METHODS</b>Clinical data of 6 patients with sinonasal hemangiopericytoma, diagnosed by pathology and immunohistochemistry between January 1990 and December 2012 were analyzed retrospectively. There were 4 males and 2 females, with a median age of 58 years. Clinical manifestation included epistaxis and nasal obstruction. These patients were operated on by nasal endoscopic surgery or endoscope-assisted surgery, of which 2 cases of tumor located in the nasal cavity underwent nasal endoscopic surgery and 4 cases of tumor located in the nasal cavity and sinuses underwent endoscope-assisted surgery.</p><p><b>RESULTS</b>All the patients were followed up for a period of 6 months to 7 years after operation. Two cases recurred and 4 cases didn't recurred. One case recurred 6 months after operation and underwent second operation, with no recurrence by further one year follow-up. Another case recurred 17 months after operation and underwent second operation, with recurrence by further 9 months follow-up. This patient lived with tumor over two years.</p><p><b>CONCLUSIONS</b>Hemangiopericytomas are rarely found in the sinonasal cavity. Nasal endoscopic or endoscope-assisted surgery provides satisfactory effect.</p>

Clinical analysis of surgical approaches and efficacy of benign occupying lesion of unilateral maxillary sinus / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the therapeutic methods and efficacy of benign occupying lesion of unilateral maxillary sinus.@*METHOD@#The clinical data of 84 patients treated with endoscopic surgery from June 2005 to June 2012 were retrospectively analyzed. Among these patients, 39 cases were treated by endoscopic surgery only, 18 cases were treated by endoscopic plus modified Caldwell-Luc technique, 15 cases were treated by endoscopic plus inferior meatus antrostomy approach, and 12 cases were treated by endoscopic anterior lacrimal recess approach. All patients were followed up postoperatively.@*RESULT@#All cases were followed up from 4 months to 7 years. Among them,81 cases had no recurrence,whereas three cases recurred during the follow-up period. All cases were preoperatively diagnosed by CT, MRI or intranasal endoscopy,which were confirmed by pathological examination postoperatively.@*CONCLUSION@#Maxillary cyst and fungal maxillary sinusitis are the major types of benign occupying lesions of maxillary sinus. According to different clinical features of benign occupying lesions of maxillary sinus,different surgical approaches should be adopted. It can not only effectively cure maxillary sinus lesions, but aslo minimize the operation trauma. Endoscopic sinus surgery is the preferred technique for treating benign occupying lesions of maxillary sinus.

Clinical analysis of nasal and laryngeal neuroendocrine carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinicopathological features, therapeutic methods and therapeutic effects of neuroendocrine carcinoma in nasal and laryngeal region.@*METHOD@#Six cases with neuroendocrine carcinoma of the nose and the larynx were analyzed retrospectively. All cases were proved by pathology and immunohistochemistry. One case was treated by only radiotherapy, and five cases by combined treatment (surgery followed by radiotherapy and chemotherapy).@*RESULT@#All the patients were followed up for a period of 11-84 months. Two cases showed recurrence after operation. Three cases occurred cervical lymph node metastasis, of which 2 cases received neck dissection and 1 case received chemotherapy and radiotherapy due to no surgical indications. Three cases occurred local recurrence, cervical lymphadenopathy, liver or lung metastases. Until the last follow up, four patients died of tumor, while two patients lived with no evidence of disease.@*CONCLUSION@#Nasal and laryngeal neuroendocrine carcinoma is composed of a group of different morphology and prognosis lesions. Corrent diagnosis depends on clinical characteristic, electron microscopic and immunohistochemical examination. CT and MRI examination could be helpful to understand the extent of disease and lesion nature. The prognosis and treatment method of neuroendocrine carcinoma were vary with different pathological types. Combined treatment based on surgery should be adopted to the disease.

The outcomes of endoscopic septorhinoplasty with three-line-tension-relaxing technique combined with nasal bone fracture correction for traumatic nasal septum deviation / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the feasibility and the efficacy of endoscopic three lines tension relaxing septorhinoplasty combined with nasal bone fracture correction for traumatic nasal septum deviation.@*METHOD@#Clinical data of 45 cases with traumatic nasal septum deviation treated were retrospectively analysed. These patients were performed with three lines tension relaxing septorhinoplasty and nasal bone fracture correction under endoscopy 5 to 14 days after injury.@*RESULT@#All patients were followed up for more than six months. They all achieved significant efficacy and no complications occurred.@*CONCLUSION@#Endoscopic three lines tension relaxing septorhinoplasty combined with nasal bone fracture correction can achieve satisfactory curative effect and can effectively prevent the occurrence of complications.

Report of 6 orbital apex syndrome caused by sinus diseases / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the diagnostic and therapeutic methods of orbital apex syndrome caused by sinus diseases and to achieve earlier diagnosis and timely treatment.@*METHOD@#Clinical data of 6 cases in our department from January 2008 to March 2012 were retrospectively analyzed.@*RESULT@#All cases had surgical treatment. All cases were preoperatively diagnosed by CT, MRI or intranasal endoscopy. The postoperative pathology showed 2 cases with fungal sphenoiditis, 2 cases with ethmoid mucocele and 2 cases with sphenoid mucocele.@*CONCLUSION@#Orbital apex syndrome caused by sinus diseases is very rare. The possible causes of misdiagnosis are low incidence of the disease, nonspecific eye symptoms, and unawareness of the doctor, especially ophthalmologist. CT, MRI or intranasal endoscopy can greatly improve the diagnosis of the disease. Endoscopic sinus surgery is a safe and effective method for orbital apex syndrome caused by sinus diseases,which is the primary therapy for the disease.

Clinical analysis of deep neck infection and its relative factors / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the diagnosis and treatment of deep neck infection.@*METHOD@#Clinical data of 45 cases treated in our department from Jan 2003 to Apr 2012 were retrospectively analysed.@*RESULT@#Nineteen cases of deep neck infection in 45 patients without abscess formation were treated with high-dose antibiotics. Performed computed tomography, the other 26 patients were treated by abscess incision and drainage, the wound healed well without complications.@*CONCLUSION@#Early diagnosis and treatment of deep neck infection is very important. Once deep neck abscess is diagnosed, early abscess surgical drainage, appropriate antibiotics and nutrition supporting treatment are effective for deep neck abscess.

Clinical analysis of nasal mucosa contact headache / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the efficacy of nasal mucosa contact point headache with the treatment of endoscopic sinus surgery.@*METHOD@#Clinical data of 75 cases with nasal mucosa contact point headache treated in our department from Jan 2008 to Nov 2011 were retrospectively analyzed. These patients were performed with endoscopic sinus surgery.@*RESULT@#All patients were followed up for more than six months. They all achieved significant efficacy and no complications occurred.@*CONCLUSION@#Nasal mucosa contact point headache and primary headache had different clinical features and different treatment. Misdiagnosis were easily made if not being carefully analyzed. Three lines tension relaxing septorhinoplasty combined with nasal bone fracture correction can achieve satisfactory curative effect and can effectively prevent the occurrence of complications. Therefore, it is necessary to strengthen the awareness of this disease. Nasal structure abnormality is the main reason of nasal mucosa contact point headache. The implementation of individualized nasal endoscopic sinus surgery can achieve satisfactory curative effect.

Clinicopathological analysis of sinonasal ectopic meningioma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the diagnostic and therapeutic methods of sinonasal ectopic meningioma.@*METHOD@#The clinical data of 8 patients treated in our department from Jan 1990 to Oct 2011 were retrospectively analysed. Among these patients, 5 cases were treated by lateral rhinotomy approach; 2 cases were treated by endoscopic plus modified Caldwell-Luc technique; 1 case was treated by endoscopic plus modified Caldwell-Luc technique. All patients were followed up postoperatively.@*RESULT@#All patients had no complications after operation. All patients were followed up from six months to 22 years. Among them, two cases had recurred 18 months and one year postoperatively. The two cases did not recur after the second operation.@*CONCLUSION@#Although sinonasal ectopic meningioma is difficult to diagnose because of their infrequent occurrence in this ectopic site and of their non-specific clinical appearance. The final diagnosis rests on the histological examination. Immunohistochemical studies are helpful to establish the accurate diagnosis. Prognosis is excellent after complete surgical resection.

Establishing a tube foam scaffold for tracheal cartilage tissue engineering by using solvent casting/particulate leaching method / 中国组织工程研究

BACKGROUND: Both aperture and porosity are mainly evaluating markers for three-dimensional poly materials. The higher the porosity is, the easier the growth and proliferation of cartilage cells are. However, with the successive increasing of porosity, compressive strength of scaffolds decreases and utility of aperture also decreases. Therefore, it is extremely significant for tracheal cartilage tissue engineering to establish three-dimensional poly scaffolds which have suitable aperture and porosity.OBJECTIVE: To establish tube foam scaffolds by using solvent casting/particulate leaching method so as to find out practical and ideal scaffolds for tracheal cartilage tissue engineering.DESIGN: Observational study.SETTING: Department of Otolaryngology, Taihe Hospital, Yunyang Medical College; Department of Otolaryngology, West China Hospital, Sichuan University.MATERIALS: The experiment was carried out in Chemical Institute, Chengdu Sub-college of Chinese Academy of Sciences from March to May 2002. Poly-D, L-lactic acid (PDLLA, Mr= 4.23×104) and sodium chloride granules (50-200 μm in diameter) were used as porogenic agent.METHODS: PDLLA was dissolved in chloroform in spherical-shape glass container to dispend 100 g/L solution and then add with sodium chloride granules (50-200 μm) based on various mass fractions of 800, 850, 900, 920, 940 and 960 g/L. Sodium chloride granules were regarded as porogenic agent (scaffolds numbered from 1 to 6) to stir and make paste suspension. Continuously, suspension was cast into tube models, heated at 90 ℃, compressed,and maintained in ventilation cabinet for 48 hours for solvent volatilization. And the resting solvent was drawn out.Form-fitting drying tube foam scaffolds were taken out and dipped in double distilled water for 48 hours so as to remove sodium chloride. The double distilled water was changed every 8 hours. Then, all tube materials were dried in vacuum drying oven for 24-48 hours. While, three-dimensional PDLLA scaffolds were successfully established.Form and intensity of scaffolds were observed with gross and scanning electron microscope; meanwhile, pore parameter was measured and analyzed.MAIN OUTCOME MEASURES: ①Gross observation of tube foam scaffolds;② measurement of pore parameters.RESULTS: ①Scaffolds were appeared as white tube foam with 8 mm in internal diameter and 12 mm in outside diameter.Scaffolds with 80-250 μm in bore and 90.6% in porosity had defined strength and ductility. ②Scanning electron microscope demonstrated that there were many holes distributed in PDLLA scaffolds in various sizes. Otherwise, hole of scaffolds was connected to each other, while big hole also contained numerous small holes. ③Porosity of scaffolds increased with the increasing mass fraction of sodium chloride; but effective porosity did not increase with the increasing mass fraction of sodium chloride. There were different effective porosities of bore (80-250 μm). Effective bore of number 4 sample was 76% and relative porosity was 90.6%. Therefore, number 4 sample was an ideal scaffold for tracheal cartilage tissue engineering.CONCLUSION: Tube foam scaffold fabricated by solvent casting/particulate leaching method is suitable for tracheal cartilage tissue engineering.