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Objective@#To evaluate the clinical significance of dissection parathyroidectomy for secondary hyperparathyroidism (SHPT) in patients with renal disease on maintenance dialysis.@*Methods@#We retrospectively reviewed 195 patients with SHPT treated in the Department of Otolaryngology & Head and Neck Surgery of Beijing Civil Aviation General Hospital between September 2009 and September 2017, including 92 males and 103 females, aged from 23 to 77 years old. There were 167 patients by operated firstly and 28 patients by operated secondly for persistent or recurrent SHPT after operation. All patients received dissection parathyroidectomy with parathyroid autograft in the sternocleidomastoid. The easement of symptoms, the levels of serum intact parathyroid hormone (iPTH), serum-ionized calcium, phosphorus, and hemoglobin were compared before and after operation. Data were analyzed by SPSS 22.0 software.@*Results@#Confirmed by postoperative pathology, a total of 804 hyperplastic parathyroid glands were removed in 195 patients with SHPT. Among them, 765 parathyroid glands were clearly identified and located with naked eye. The anatomic distribution of the glands showed 577 (75.4%) in the tracheoesophageal groove. The incidence of ectopic parathyroid glands was 24.6% (188/765). Other 39 (4.9%) hyperplastic parathyroid glands from 22(11.3%) patients, which were not identified and located with naked eye during operation, were pathologically detected in the dissected tissue specimens. Among 195 patients, 28(14.4%) showed supernumerary parathyroid glands. No serious complications occurred after operation. Within 6 months after the operation, the bone pain and skin itch symptoms were completely relieved and, also, the symptoms of muscle weakness, restless leg, anemia and poor sleep quality were significantly alleviated. Following-up at 6 months after surgery showed the serum levels of iPTH [(70.31±60.12) pg/ml], calium [(2.13±0.22) mmol/L], and phosphorus [(1.17±0.27) mmol/L] decreased significantly respectively compared with the preoperative serum levels of iPTH [(1 501.02±167.26) pg/ml], calium [(2.40±0.32) mmol/L], and phosphorus[(2.27±0.50)mmol/L], all with statistically significant differences (P<0.01); the levels of hemoglobin [(120.32±10.63) g/L] and hematocrit [(39.20±3.21)%] were higher than the preoperative levels of hemoglobin[(104.11±15.17) g/L] and hematocrit [(31.25±5.12)%], both with statistically significant differences (t valve was 12.22,18,37,respectively, all P<0.05).@*Conclusions@#Dissection parathyroidectomy is a beneficial and safe surgical procedure for patients with medically refractory SHPT.
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OBJECTIVE: To investigate the effect of temperature and time on the detection results of calcium and magnesium in urinary sample storage. METHODS: Urinary samples of 5 health volunteers were collected. The samples were stored in room temperature, 4 ℃ and-20 ℃ for different duration after sealed separately. A flame atomic absorption spectrometry was used to detect calcium and magnesium mass concentrations in the urinary samples. RESULTS: The variation rate of calcium and magnesium mass concentrations was <2.00% when urinary samples were stored at room temperature for 8 hours, the variation rate was <6.00% when samples were stored at 4 ℃ for 15 days, and it was <5.00% when samples were stored at-20 ℃ for 60 days. CONCLUSION: The temperature and time of urinary sample storage can affect the detection results of calcium and magnesium mass concentrations. Packing and storing samples at low temperature after collection as soon as possible is beneficial to ensure the accuracy of test results.
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Objective To investigate the depression of patients with Meniere disease after surgery ,and the relationships to vertigo and the improvement of the quality of life .Methods A total of 46 patients with Meniere dis-ease and 95 patients with other diseases of otorhinolaryngology (as control) were enrolled in this retrospective stud-y .They underwent operations between 2013 and 2015 .They finished self -rating depression scales ,Meniere dis-ease outcomes questionaire by snail mail .They were asked about the frequencies of vertigo before and after surgery . The gender ,age and postoperative course in the control group were matched to those of in the Meniere group .The relationships among vertigo ,the improvement of the quality of life and postoperative depression were compared .Re-sults In the Meniere group ,69 .77％ of patients did not have depression ,while 13 .95％ were with mild depres-sion ,16 .28％ with moderate ,none with severe .Depression was more severe in the Meniere group than in the con-trol group .There were no obvious linear relationships between vertigo and depression or between quality of life and depression .There was no statistical difference in depression of patients with different vertigo frequencies .Conclusion There is still a certain degree of postoperative depression in near 30％ of patients with Meniere disease after sur-gery .This may not be related to vertigo nor the quality of life .
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To investigate the postoperative anxiety and its relationship with life quality in patients with Ménière's diseases. Methods: A total of 68 patients with Ménière's disease, who received the treatment of endolymphatic sac decompression from 2010 to 2016, were enrolled. They finished two scales (the self-rating anxiety scale and the quality of life questionnaire for endolymphatic sac decompression of Ménière's disease) by snail mail. The patients were divided into different groups based on their preoperative course, postoperative follow-up time, clinic stage and quality of life after endolymphatic sac decompression surgery, and their anxiety was analyzed. In addition, 109 gender and age-matched patients with other diseases of otorhinolaryngology served as the control group, and their anxiety was also analyzed. Results: There was no statistical difference in the postoperative anxiety among the patients with preoperative course for less than 1 year, 1 to 5 years or more than 5 years (all P>0.05). There was no statistical difference in the patients with different duration of follow-up (P>0.05). There was no statistical difference in the patients with the different clinic stages (all P>0.05). There was no statistical difference in the patients with the improved life or non-improved life after surgery (P>0.05). The degree of the anxiety in the Ménière's group was more severe than that in the control group (P<0.01). Conclusion: It needs to keep in mind that a certain degree of postoperative anxiety still keeps in patients with Ménière's disease.
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Humans , Anxiety , Anxiety Disorders , Case-Control Studies , Decompression, Surgical , Methods , Endolymphatic Sac , General Surgery , Meniere Disease , Psychology , General Surgery , Postoperative Complications , Psychology , Quality of LifeABSTRACT
OBJECTIVE To make a research on the diagnostic value of Magnetic resonance image for preoperative localization of the parathyroid glands in secondary hyperparathyroidism patients.METHODS This retrospective study was on 51 patients with secondary hyperparathyroidism who underwent parathyroid gland resection and autoplastic transplantation and were examined with Magnetic resonance imaging 99mTC-MIBI nuclide imaging and Color doppler ultrasound in our hospital from 2010 to 2016.Compare to the gold standard of pathological diagnosis after operation,the sensitivity of various imaging examination on identifying the parathyroid glands were calculated.RESULTS The number of parathyroid glands diagnosed by pathology was 197,including 180 conventional parathyroid glands and 17 eetopic parathyroid glands.The sensitivity of MRI,99mTC-MIBI nuclide imaging and Color doppler ultrasound on identifying the conventional parathyroid glands was 76.67％,51.11％ and 44.44％ respectively,and the sensitivity on identifying the ectopic parathyroid was 29.41％,0 and 0 respectively.Sensitivity of the Magnetic resonance on identifying the conventional parathyroid and the ectopic parathyroid imagin were better than 99mTC-MIBI nuclide imaging and color doppler(P＜0.05).CONCLUSION Magnetic resonance imaging is an effective auxiliary examination on preoperative localization of the parathyroid glands in secondary hyperparathyroidism patients and can be the first choice of the image examination.
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A 70 years old male patient complained a sense of swelling on right facial, mild pain, and the obstruction of right nasal, no complain of facial numbness and toothache. Physical examination showed the slight bulging on right facial with mild tenderness, purulent nasal secretions on the right middle nasal meatus, and no significant neoplasm. CT scan showed that soft density tissue in the right maxillary sinus,and the high density tissue in some period. Postoperative diagnosis: carcinoma of maxillary sinus with fungal sinusitis.
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Aged , Humans , Male , Carcinoma , Diagnosis , Maxillary Sinus , Microbiology , Pathology , Mycoses , Nose Neoplasms , Diagnosis , Sinusitis , MicrobiologyABSTRACT
OBJECTIVE To investigate the clinical manifestation,diagnosis and treatment of Castleman disease(CD)in the neck. METHODS The data of 2 patients with pathological proved CD in the neck,who were seen in our hospital,were reviewed retrospectively in order to analyze their clinical manifestations,clinical and histological types, imaging characteristics and treatment. RESULTS The age of onset were 24 and 29 years respectively. Both of them only presented as a solitary,painless neck mass and met the criteria of localized CD, and also had histological evidence of the hyaline vascular variant. Complete surgical resection was the first treatment.Both of them were alive without evidence of recurrence for one year and half a year respectively. CONCLUSION CD in the neck often presents as localized lesion,which often presents as a progressive, painless, slowly growing lymph node enlargement that is generally asymptomatic. The locations most commonly are the cervical lymph nodes. CD in the neck is almost always the hyaline-vascular variant and complete surgical excision of the tumor is the best treatment.
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0.05). CONCLUSION The sound localization apparatus can test the localization ability of person, and it can be used in simply and reasonably.
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OBJECTIVE To explore the possibility of no recurrent laryngeal nerve injury in thyroid surgery. METHODS A total of 659 consecutive patients with thyroid disease undergoing thyroidectomy byotolaryngologists from March 2001 to March 2005 were retrospectively analyzed. The operative mode and incidence of complications, particularly postoperative RLN palsy, hypoparathyroidism and postoperative recurrence were evaluated. Routine dissection and identification of the RLN was performed during all operative procedures and parathyroid with the blood supply was preserved. RESULTS Unilateral total thyroidectomy with contralateral partial lobectomy was performed in 376 cases, unilateral total thyroidectomy with isthmectomy in 87, bilateral subtotal thyroidectomy with the remnant left at the upper pole in 76, total thyroidectomy in 73. The operations on 47 patients with substernal goiter have been successfully performed via cervical collar incision. None of our patients incurred unilateral or bilateral vocal cord paralysis and permanent hypocalcaemia. Of these patients, the incidence of temporary postoperative hypocalcemia was 1.67 %(11/659). Postoperative hemorrhage requiring reoperation occurred in 4 cases (0.60 %) and 5 patients developed wound haematomas (0.76 %).Postoperative hypothyroidism was found in 3 patients(0.45 %).The incidence of postoperative recurrence was 0.15 %(1/659). No patients had incision infection. CONCLUSION With knowledge of the anatomy of the RLN and routinely complete identification the RLN in performing capsular dissection high on the surface of the thyroid gland, RLN injury may be avoided in thyroid surgery. [