ABSTRACT
Objective To investigate the effectiveness of head and neck cancer patient subjective assessment of forecast of the disease and prognosis .Methods 79 patients with head and neck squamous cell carcinoma were col-lected for newly diagnosed cases .Swal-QOL scale and EuroQOL-5D-3L questionnaire was used to detect subjec-tive evaluation .Clinical adult disease assessment scale -27 evaluation was used to detect objective assessment of the extent of the disease .The tumor organization standard was used to evaluate physical state .Results The average follow-up time was 29 months(4~65 months),19 patients died during the follow -up period,the main causes of death were tumor progression(63.2%).0%~5%decreased body mass of 73.4%patients,60 patients(75.9%) between ACE-27 grade was between 0~1,47 patients(59.5%) ECOG score between 0~1.T staging,loss of body mass ra-tio,sex with multiple patient subjective evaluation index ( daily gain ability , pain or discomfort and dysphagia ) , the differences were statistically significant ( OR=1.9~7.7,P<0.05).Conclusion The correlation is higher in pa-tients with head and neck cancer subjective evaluation and clinical indexes ,which can well predict the severity and duration of tumor .Dysphagia is the most effective index for evaluating tumor mortality rate .
ABSTRACT
OBJECTIVE@#To discuss the method and effect of exercising larynx and genioglossus to treat obstructive sleep apnea hypopnea syndrome (OSAHS).@*METHOD@#Fifty-four patients who were diagnosed as OSAHS and exercised larynx and genioglossus were defined as treatment group. We took Epworth sleep scale, check patient's PSG, and took computer tomography (320CT) before treatment, 6 months and 12 months later. We made a record of AHI, LSaO2, BMI, the shortest sagittal diameter and transverse diameter. Compared with 30 patients who had taken UPPP surgery (control group 1) and the 21 patients without any treatment (control group 2) at the same time. SPSS 10.0 was used to analyze the data.@*RESULT@#According to Chinese OSAHS construction in 2009, 6 months and 12 months later, the effective rates of treatment group were 31.48% and 44.44%, among which the effective rates in mild and moderate patients of treatment group were 44.74% and 63.16%. Before treatment the mark of Epworth sleep scale was 7.67, 6 month and 12 month later the marks were 3.54 and 3.25. AHI were up to 15.45 after 6 months and 13. 60 after 12 months from 22. 84 at the beginning. LSaO2 were up to 81.18% after 6 months and 81.93% after 12 months from 74.05% at the beginning. The effective rate of control group 1 was 66.67%, and was much higher than the treatment group 6 months later (P 0.05). The effective rates of treatment group were much higher than control group 2 (P < 0.01). After 12 months, the sagittal wall compliance of retropalatal area was lower (P < 0.01). There was no significant change of BMI in every group.@*CONCLUSION@#Exercising larynx and genioglossus is one kind of non-invasive and effective method without payment to treat part of OSAHS patients, especially the patients who is old, without surgical condition, and especially mild and moderate OSAHS patient that do not want to take surgery and CPAP treatment. Besides, exercising larynx and genioglossus can be considered as remedial treatment of OSAHS to surgery and other therapy.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Exercise Therapy , Muscle, Skeletal , Pharynx , Sleep Apnea, Obstructive , TherapeuticsABSTRACT
OBJECTIVE@#To evaluate diagnostic significance of the noninvasive and objective 320-slice CT scan in the high pharynx resilience in the patients with obstructive sleep apnea/hypopnea syndrome.@*METHOD@#Fifty patients with OSAHS and 10 patients with pharyngeal paraesthesia were included in the study. 320 slice CT scan was used to measure the sagittal diameters, transverse diameters and sectional area of the retropalatal region, retroglossal region. Calculating the pharynx wall resilience. Analyzing the correlativity of pharynx wall resilience, BMI and AHI. Fiber endoscope was used to assess the subsidence percentage of the pharynx wall.@*RESULT@#Between OSAHS patients and pharyngeal paraesthesia patients, there was obviously difference in the retropalatal region and retroglossal region upper airway. The pharynx wall resiliences of retropalatal region were much more than that of retroglossal region. The later pharynx wall resiliences were much more than the fore-to-aft pharynx wall resiliences in the retropalatal region. BMI, AHI and the pharynx wall resilience were positive correlative to each other. But AHI and the pharynx wall resilience was nonlinear correlative. There was a good concordance between the pharynx wall resilience detected by 320CT and subsidence percentage of the pharynx wall detected by fiber endoscope.@*CONCLUSION@#320 slice CT is a kind of simple, rapid and objective method to localize the high resilience area of upper respiratory tract, which can be benefit to the clinical diagnosis, the etiological study and the treatment of OSAHS. Based on physical examination, we propose that only one time of CT scan to the patients' upper airway at the Muller' stage is enough to localize the stenosis area, which can reduce radiation dosage dramatically.