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Objective:To investigate the feasibility and clinical effect of the surgical approach and method of transnasal fenestration under nasal endoscope for the treatment of maxillary odontogenic cyst. Methods:The clinical data of 23 cases with maxillary odontogenic cysts treated by nasal endoscopy through nasal fenestration were retrospectively analyzed. All cases underwent nasal endoscopy and CT examination before the operation. The mucosal membrane of the parietal wall of the cyst was excised through fenestration of the nasal base. The cyst fluid was removed by decompression, and the bony opening of the nasal base was trimmed and enlarged to the edge of the cyst. The intraoperative and postoperative effects were observed. Results:All cases were well exposed under the direct vision of nasal endoscope. The top wall of the cyst was removed to maximize the communication between the cyst cavity and the nasal floor. There were no complications such as nasolacrimal duct injury, turbinate atrophy, necrosis, and facial numbness. All patients were followed up for 6-12 months, and the clinical symptoms gradually disappeared after surgery. The inferior turbinate was in good shape, the cyst cavity was smooth, the cyst wall was determined, and no cyst recurrence was observed. Conclusion:The treatment of odontogenic cyst of maxilla under nasal endoscope through nasal fenestration is convenient. It has less trauma, fewer complications and a satisfactory curative effect, which is worthy of clinical promotion.
Subject(s)
Humans , Maxilla , Retrospective Studies , Odontogenic Cysts/surgery , Endoscopy , Turbinates/surgery , EndoscopesABSTRACT
Objective To investigate the effects of exosomes derived from human dental pulp mes-enchymal stem cells ( hDPSC-exosomes) on the maturation and function of dendritic cells ( DC) stimulated by lipopolysaccharide ( LPS ) , and to evaluate their regulatory effects on the immune system. Methods Adult permanent teeth-derived dental pulp mesenchymal stem cells were cultured in vitro to extract exosomes in the cell culture medium. The morphology and sizes of the exosomes were observed under transmission electron microscopy. Expression of CD9 and CD63 on the surface of the exosomes was detected by Western blot. PBS, LPS and LPS+hDPSC-exosomes were respectively used to stimulate mouse bone marrow-derived dendritic cells (DC2. 4) for 24 h. A blank control group was set up accordingly. Expression of co-stimulato-ry molecules and cytokine secretion were detected by flow cytometry and ELISA, respectively. Expression of TLR2, TLR4 and NF-κB at mRNA level was detected by RT-PCR. Changes in the functions of DC were evaluated by mixed lymphocyte reaction ( MLR) . Results Adult permanent teeth-derived dental pulp mes-enchymal stem cells were successfully isolated. Up-regulated CD73 and CD90, and down-regulated CD45 were detected on the surface of the cells. Under electron microscopy ( SEM ) , hDPSC-exosomes showed round or oval microcapsule bodies about 50-80 nm in diameter with positive surface markers of CD9 and CD63. hDPSCs-exosomes could significantly reduce the LPS-induced expression of co-stimulatory molecules CD11c and CD86 on DC surface. Moreover, hDPSCs-exosomes increased TGF-β expression and decreased IL-4. They could also significantly inhibit the proliferation of splenic lymphocytes that was induced by DC af-ter LPS stimulation. Compared with the blank control group, hDPSC-exosomes could promote the expression of TLR2 and TLR4 on DC surface and up-regulate the expression of NF-κB. Conclusions This study showed that hDPSC-exosomes could inhibit the activation and functional maturation of DC, promote the de-velopment towards tolerant DC through TLR-NF-κB signaling pathway, and induce immune tolerance to regu-late immune balance.
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OBJECTIVE To study the anatomic relationship of the divus region and provide the anatomical basis for the extended endoscopic endonasal approach to clivus region.METHODS 10 cadaveric heads were dissected using the surgical microscope and endoscope.RESULTS 1.With the extended endoscopic endonasal approach,we can expose the ventral side of brain stem from interpeduncal fossa to the foramen magnum and upper,middle,and lower neurovascular complexes.2.The clivus region,formed by the sphenoid body and the clival part of occipital bone,is situated between the dorsum sellae and the anterior margin of the foramen magnum.Occipital bone and the petrous part of the temporal bone were separated by the petroclival fissure.CONCLUSION 1.The extended endoscopic endonasal approach can be tailored to deal with the local lesions involving the clivus and adjacent posterior cranial fossa structures.2.Full andcomprehensive understanding of the anatomy around the clivus region can help surgeons to improve accuracy and safety of procedures in this region.
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The clival region refers to the skull base between dorsum sellae and anterior border of foramen magnum. It is located in central area of skull base and is in close proximity to pons, medulla oblongata, basilar artery and other crucial intracranial structures. Although there are various microsurgical approaches using craniotomy to reach this region, there are still a lot of difficulty in exposure of clivus. With the increasing development in extended endoscopic endonasal approach, a new route to clivus, as well as meticulous endoscopic anatomy studies is emerging. This article reviewed related researches progress of the detailed anatomical studies from endoscopic perspective.
Subject(s)
Humans , Cranial Fossa, Posterior , Craniotomy , Endoscopy , Methods , Nasal Surgical Procedures , Methods , Nose , Skull BaseABSTRACT
OBJECTIVE@#To describe the anatomy,radiographic manifestation, and surgical treatment of pulsatile tinnitus due to sigmoid sinus diverticulum.@*METHOD@#The retrospectively study of diagnosis,clinical and radiographic manifestations,and surgical treatment of 2 cases of pulsatile tinnitus caused by sigmoid sinus diverticulum was carried out.@*RESULT@#Bony defect was found in the anterior sigmoid wall in both cases, and one of them was combined with invasion of soft tissues in mastoid cells. Both of them undertook a surgery to reconstruct sinus wall and received a satisfactory results.@*CONCLUSION@#Sigmoid sinus diverticulum is one of causes which lead to pulsatile tinnitus. It can be identified by imaging examination and can be cured by sinus wall reconstruction.
Subject(s)
Adult , Female , Humans , Male , Diverticulum , Meninges , Retrospective Studies , Tinnitus , Pathology , General SurgeryABSTRACT
[Objective] To compare the disinfection effect of different disinfectants on disinfection effect of laryngeal endoscope,and seek for a more safe and effective disinfectant for laryngeal endoscope.[Methods] 180 laryngeal endoscope were divided into three groups with 60 of them in each group.Acidic electrolyzed oxidizing water(AEOW),2％ glutaraldehyde and orthophthalaldehyde were used for disinfection.Three minutes and five minutes after disinfection,the samples were got and underwent bacterial detection.The disinfection effect after three minutes and five minutes was compared.[Results] The qualified rate of disinfection and cost between AEOW,2％ glutaraldehyde and orthophthalaldehyde showed distinct difference.[Conclusions] Using acidic electrolyzed oxidizing water in the disinfection of laryngeal endoscope has advantages of fast,effective,low-cost,which can be applied in the clinical work.
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OBJECTIVE To investigate the protein kinase C (PKC) activity in peripheral blood T lymphocytes and its significance in patients with allergic rhinitis (AR) and the relationship between PKC activity and Th2 cytokines, interleukin 4 (IL-4) and interleukin 5 (IL-5) . METHODS Twenty seasona allergic rhinitis patients and 20 normal control persons participated in the study. T lymphocytes isolated and purified from blood of each person were divided into 2 groups:stimulated with and without phorbol 12-myristate 13-acetate (PMA) . The total PKC activity was detected by non-radioactive assay. The expression of IL-4 and IL-5 protein in supernatants was measured with ELISA RESULTS PKC activity, the expression of IL-4 and IL-5 protein in supernatants in AR T lymphocyte stimulated with PMA were significantly higher than those of AR T lymphocyte stimulated without PMA and those of norma (P