Analyzing the efficiency of increasing blood pressure before the end of the operation to reduce post coblation assisted tonsillectomy hemorrhage / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the efficiency of reducing post-tonsillectomy hemorrhage by increasing blood pressure before the end of the coblation operation.METHODS Clinical data of 1069 patients with coblation assisted tonsillectomy under general anesthesia between January 2008 and January 2016 were retrospectively reviewed.The treatment group were 546 patients checked the operation cavity after increasing blood pressure before the end of tonsillectomy,while the control group were 523 patients checked the operation cavity with routine procedure without increasing the blood pressure.Post-tonsillectomy hemorrhage incidence and postoperative bleeding volume were compared between the two groups.RESULTS Checking the operation cavity after increasing blood pressure before the end of tonsillectomy can reduce the incidence of postoperative primary hemorrhage (P＜0.05),but cannot reduce the incidence of postoperative secondary hemorrhage (P＞0.05).CONCLUSION Increasing blood pressure before the end of tonsillectomy can effectively reduce the incidence of postoperative primary hemorrhage.

Analysis of clinical diagnosis and treatment of 112 cases of parapharyngeal space tumors / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the diagnosis, treatment and surgical approaches of parapharyngeal space tumors.@*METHOD@#This retrospective study consisted of 112 patients with parapharyngeal space tumors underwent surgeries. The data included clinical symptoms and signs, pathological types, imaging examinations, surgical approaches and postoperative complications.@*RESULT@#Computerized tomography (CT), magnetic resonance imaging (MRD and digital subtraction angiography (DSA) made clear the tumor size, localization and its relation to adjacent structures. The postoperative histopathology varied and showed benign in 98 cases consisting of salivary gland tumors (52 cases), neurogenic tumors(33 cases) and other types (13 cases). During the 3 years follow-up period, local recurrence appeared in 3 patients with salivary pleomorphic adenoma and 1 patient with neurofibromatosis. These recurrent tumor cases were cured with second surgery. In 14 patients with malignant tumors reported, 8 cases survived for 5 years, 2 cases (1 adenoid cystic carcinoma and 1 carcinoma in pleornorphic adenoma) recurred in the two and a half years cured with second surgery affiliated radiation therapy through 3 years follow-up time and the rest were followed up 1 to 3 years without recurrence. Peripheral facial paralysis was observed in 25 patients, and 3 patients experienced hypoglossal nerve palsy. Only 1 patient encountered vagus nerve injury, and 2 patients appeared Horner's syndrome, and 4 patients endured Frey syndrome. Gills leakage was discovered in 3 cases and cavity infection was noted in 1 patient.@*CONCLUSION@#CT, MRI and DSA were important in the diagnosis and differential diagnosis of parapharyngeal space tumors. The key to successful treatment is knowing the anatomy of the parapharyngeal space, preoperative assessment and appropriate surgical approach.

The application of decompression in the treatment of gnathous cystic lesions / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the application of decompression in the treatment of ganthous cystic lesions.@*METHOD@#Decompression surgery were performed on 32 patients with gnathous cystic lesions, the cavities of cysts were open and the cysts pressure was relieved. The cavities of cysts were flushed after the operation and the prognosis were assessed in the regular follow-up.@*RESULT@#All cysts cavities were shrinks afer decompression operation. Through the X-line and/or CT scans, we could observe that the new bones formed around cysts cavities, tilt shift teeth were gradually corrected and the permanent tooth germs of pediatric patients almost returned to the right places and erupted; There were the only remaining small bone indentations in the 18 cases, which do not need the Phase II surgery. Eight cases of cysts cavities shrinks more than 50%, which needed cystectomy. Six cases of cysts cavities shrinks less than 50%, which were still in the follow-up treatment.@*CONCLUSION@#The decompression surgery is a simple, economical and effective method for the treatment of gnathous cystic lesions.

Isolated sphenoid sinus disease presented the primary symptom as headache or ocular disturbance / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To improve the understanding of the symptoms and signs of isolated sphenoid sinus disease and decrease the occurrence of misdiagnoses.@*METHOD@#The clinical manifestation and the advantage of endoscopic sinus surgery were analyzed in 22 cases of isolated sphenoid sinus disease.@*RESULT@#Twelve cases had endoscopic sphenoidotomy, 7 cases had external ethmoidal sphenoidotomy, 3 cases had antibiotic, steroid and neurotrophic therapy. All of the patients were free of headache,improvement in vision and ocular motility after treatment. After 3 to 6 months' follow up, 1 case recurred and symptom relieved after endoscopic sinus surgery. 1 case adenoid cystoid carcinoma underwent post operative radiotherapy without recurrence after 3 years follow up.@*CONCLUSION@#Isolated sphenoid sinus disease presented the primary symptom as headache and/or ocular disturbance is prone to be misdiagnosed, application of CT, MRI and endoscopy improve its diagnosis and treatment standard. Endoscopic sinus surgery is the primary therapy for isolated sphenoid sinus disease.