Experience of Fusion image guided system in endonasal endoscopic surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To review endonasal endoscopic surgeries aided by Fusion image guided system, and to explore the application value of Fusion image guided system in endonasal endoscopic surgeries.@*METHOD@#Retrospective research. Sixty cases of endonasal endoscopic surgeries aided by Fusion image guided system were analysed including chronic rhinosinusitis with polyp (n = 10), fungus sinusitis (n = 5), endoscopic optic nerve decompression (n = 16), inverted papilloma of the paranasal sinus (n = 9), ossifying fibroma of sphenoid bone (n = 1), malignance of the paranasal sinus (n = 9), cerebrospinal fluid leak (n = 5), hemangioma of orbital apex (n = 2) and orbital reconstruction (n = 3).@*RESULT@#Sixty cases of endonasal endoscopic surgeries completed successfully without any complications. Fusion image guided system can help to identify the ostium of paranasal sinus, lamina papyracea and skull base. Fused CT-CTA images, or fused MR-MRA images can help to localize the optic nerve or internal carotid arteiy . Fused CT-MR images can help to detect the range of the tumor. It spent (7.13 ± 1.358) minutes for image guided system to do preoperative preparation and the surgical navigation accuracy reached less than 1mm after proficient. There was no device localization problem because of block or head set loosed.@*CONCLUSION@#Fusion image guided system make endonasal endoscopic surgery to be a true microinvasive and exact surgery. It spends less preoperative preparation time, has high surgical navigation accuracy, improves the surgical safety and reduces the surgical complications.

Aneurysmal bone cyst of the mastoid bone: one case report / 临床耳鼻咽喉头颈外科杂志

Aneurysmal bone cyst of mastoid bone is seldom, here one case was reported. The mastoid bone of the patient presented with a baloon-like swelling full of non-coagulated blood and serous-hemorrhagic fluid. CT scan demonstrated a large expansile destructive mass located in left mastoid bone region with the thin or absent cortical bone. The MRI demonstrated T2-weighted images and clear boudary from surrounding tissue. Pathologic reported that the mastoid bone was repalcement with lacunar divided by fibro-tissue, containing numerous hemosiderin, giant cells and inflammatory cells. A surgery was performed and the patient was cured.

Clinical analysis and literature review of primary melanoma in nasal cavity and sinus--report of 9 cases / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze and summarize clinical characteristic, treatment scheme and survival rate of primary melanom in nasal cavity and sinus.@*METHOD@#We retrospectively analyzed the 9 patients with primary melanom in nasal cavity and sinus who in data proceed were treated and reviewed the related literature.@*RESULT@#Among the 9 patients, the clinical main symptoms are rhinostegnosis of lateral nasal and intermittent nasal bleeding. Pathologic examination is mainly characterized by tumor cells abnormity and cytoplasm containing pigment or without pigment, and main diagnosis basis is some or all of the positive for HMB45, S-100, melan-A. The survival rate are 88.9% (8/9) of 1-year, 66.7% (6/9) of 3-year and 33.3% (3/9) of 5-year.@*CONCLUSION@#The incidence of primary melanom in nasal cavity and sinusis is not frequent in clinic and confirmed by immunohistochemical. The extensive radical excision of focus and combine adjuvant radiotherapy postoperative may improve the survival rate of patients.

Factors influencing olfactory dysfunction in patients with chronic rhinosinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the relative factors influencing olfactory dysfunction in patients with chronic rhinosinusitis (CRS).@*METHOD@#Visual analogue scale (VAS) was applied to measure the severity of olfactory dysfunction of 270 patients with CRS. Patients were divided into two groups, one was that the quality of life (QOL) of patients was affected by olfactory dysfunction (VAS > 5), the other was that without QOL affected by olfactory dysfunction (VAS ≤ 5). The association between age, gender, nasal polyps, allergic rhinitis, smoking history, early nasal surgery history and other clinical factors, and serum total IgE level, peripheral blood eosinophil count, peripheral blood mononuclear cell count and olfactory dysfunction was analyzed.@*RESULT@#The number of patients with nasal polyps, allergic rhinitis, previous nasal surgeries, the level of serum total IgE, and the severity of edema were significantly increased in patients with impaired QOL associated with olfactory dysfunction (P 0.05). Serum total IgE increased (OR = 1.003, P < 0.01) and severe edema (OR = 2.483, P < 0.01) were the risk factors for the impairment of olfactory function, more notably for edema; whereas previous nasal surgeries was a protective factor (OR = 0.408, P < 0.01).@*CONCLUSION@#Sever edema and increased serum total IgE are risk factors, whereas previous nasal surgeries history is a protective factor for the olfactory dysfunction.

The expression of NOD1 and NOD2 and the regulation of glucocorticoids on them in allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression of NOD1 and NOD2 in the nasal mucosa of healthy individuals and allergic rhinitis(AR), and explored the regulation of glucocorticoids on them.@*METHOD@#RT-PCR and immunohistochemistry were used to detect the expression of NOD1 and NOD2 in nasal mucosa from healthy control and AR. Nasal explant culture was used to explore the effect of glucocorticoids on NOD1 and NOD2 expression.@*RESULT@#NOD1 and NOD2 mRNA expression level was significantly increased in AR compared with control. Immunohistochemical staining demonstrated that NOD1 and NOD2 were mainly expressed by epithelial cells and some unknown cells in lamina propria and there were significantly more positive staining cells were observed in AR tissue when compared with control. Glucocorticoids down-regulated NOD1 and NOD2 expression in AR.@*CONCLUSION@#NOD1 and NOD2 as two PRRs may take part in the pathogenesis of AR, glucocorticoids may play a therapeutical role on allergic rhinitis through down-regulated the expression of NOD1 and NOD2.

A Contrastive Analysis on the Value of Tympanograms and of Temporal Bone CT Scans in Diagnosis of Secretory Otitis Media / 听力学及言语疾病杂志

Objective To investigate and contrastive analyse the respective value of tympanograms and high resolution CT scan of temporal bone in the diagnosis of secretory otitis media .Methods The clinical data of 150 hos-pitalized patients with secretory otitis media in Department of ENTHNS ,Tongji Hospital ,Wuhan from 2009 to 2012 were retrospectively analyzed .Based on the surgical finding of tympanic cavity fluid ,the diagnostic accordance rate of tympanograms and temporal bone CT for middle ear effusion were calculated respectively ,and their diagnos-tic value were evaluated .Results The diagnostic accordance rate of tympanogram B for the middle ear effusion in secretory otitis media was 94 .5% (138/146 ears) ,the rate of abnormal tympanograms was 91 .6% (206/225 ears) , while temporal bone CT with a rate of 99 .2% (117/118 ears) .The difference between the latter two data was statis-tically significant(P<0 .01) .Conclusion The temporal bone CT scan ,with a higher diagnostic value for middle ear effusion in secretory otitis media ,could be used as a supplement to the acoustic immittance measurement ,especially to non-B tympanograms for the diagnosis of secretory otitis midia .

Mast cell and its relation to eosinophilic inflammation in CRSsNP / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the pathologic characteristics, and investigate mast cell and its activation in chronic rhinosinusitis without nasal polyps (CRSsNP) and their relations with eosinophilic inflammation.@*METHOD@#HE stain was used to observe tissue features and count total inflammatory cells, mononuclear cells, plasma cells and eosinophilic in lamina propria of CRSsNP and inferior turbinate. Toluidine blue stain and immunohistochemical stain for tryptase were used to detect mast cell and its activation respectively in CRSsNP and control, and their corelations with tissue eosinophilia were analysed.@*RESULT@#CRSsNP has increased total inflammatory cells, mononuclear cells and plasma cells but comparable eosinophilic and lamina propria glands compared with inferior turbinate. Mast cells corelated with activated mast cells, but there was no difference between CRSsNP and control for both of them and there were no corelation between mast cell and its activation with tissue eosinophilia.@*CONCLUSION@#CRSsNP has more serious inflammation but no more mast cell and its activation and eosinophil compared with inferior turbinate, and there were no corelations between mast cell and its activation with eosinophil count which suggests that mast cell and eosinophilic inflammation mediated by it may not play an important role in the pathogenesis of CRSsNP.

The expression of oncogene c-myc and its role on human laryngeal cancer / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To detect the expression of oncogene c-myc and explore its role on human laryngeal cancer.@*METHOD@#The mRNA and of oncogene c-myc levels were detected in human laryngeal cancer tissues and laryngeal normal tissues by the means of real-time PCR and immunohistochemistry, respectively.@*RESULT@#Compared with normal laryngeal tissues, the mRNA and protein levels of oncogene c-myc were both upregulated in laryngeal cancer tissues of all differentiation degree (P<0.05). Moreover, the level of c-myc was inverse correlated with the differentiation degree in human laryngeal cancer tissues.@*CONCLUSION@#The oncogene c-myc is overexpressed in human laryngeal cancer tissues, and c-myc may play an important role in carcinogenesis and progression of human laryngeal cancer tissues. It may provide a new target for gene therapy of human laryngeal cancer.

The expression of oncogene c-myc and its role on human laryngeal cancer / 临床耳鼻咽喉头颈外科杂志

Objective:To detect the expression of oncogene c-myc and explore its role on human aryngeal cancer.Method:The mRNA and of oncogene c-myc levels were detected in human laryngeal cancer tissues and iaryngeal normal tissues by the means of real-time PCR and immunohistochemistry,respectively.Result:Compared with normal laryngeal tissues,the mRNA and protein levels of oncogene c-myc were both upregulated in laryngeal cancer tissues of all differentiation degree(P＜0.05).Moreover,the level of e-myc was inverse correlated with the differentiation degree in human laryngeal cancer tissues.Conclusion:The oncogene c-myc is overexpressed in human laryngeal cancer tissues,and c-myc may play an important role in carcinogenesis and progression of human laryngeal cancer tissues.It may provide a new target for gene therapy of human laryngeal cancer.

Expression and significance of PD-L1 in laryngocarcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the expression of ligand 1 of programmed death-1 (PD-L1) in human laryngocarcinoma tissues and peritumoral tissue and its potential significance to clinic.@*METHOD@#Immunohistochemistry and Western-blotting were performed to assess the expression of PD-L1 at protein level and the differences in 31 cases of laryngocarcinoma tissue and 24 cases of paraneoplastic tissue.@*RESULT@#Expression of PD-L1 was significantly higher in poorly and moderately differentiated larynx squamous carcinoma than that in well differentiated larynx squamous carcinoma. The expression of PD-L1 in the former was mainly in blood vessels while rarely in cancer cells, and the blood vessel of the latter displayed weakly positive while partial cancer cells showed positive; and the expression of PD-L1 was significantly correlated with lymphatic metastasis. Expression of PD-L1 in paraneoplastic tissues was significantly lower than that in cancer tissues but positively correlated to the expression level in the cancer tissues.@*CONCLUSION@#PD-L1 may play a part in the development and/or metastasis of laryngocarcinoma, particularly in the bad differentiated; And it maybe a new target of immunotherapy for laryngocarcinoma, especially for the poorly and moderately differentiated.