Application of individualized selection of local skin flaps for primary repair of partial nasal alar defects / 中国医师进修杂志

Objective:To explore the possibility of repairing partial nasal alar defects with individualized design of localized skin flaps.Methods:The clinical data of 38 patients with nasal alar region tumor from October 2015 to June 2019 in Dalian Municipal Central Hospital were retrospectively analyzed, including 5 cases with intradermal nevus, 8 cases with junction nevus, 21 cases with basal cell carcinoma, 3 cases with trichoepithelioma, and 1 case with nasal alar sulcus fistula combined with infection. Surgical treatment with local anaesthesia was applied, and intraoperative freezing pathology was used to confirm the diagnosis and determine the safe margin. There was no nasal alar cartilage infiltration in all patients. The defect areas after resection of nasal alar lesions ranged from 1.0 cm × 1.0 cm to 3.0 cm × 2.5 cm. Local skin flap was aesthetically designed in accordance with the location and size of the nasal alar defect to primarily repair the defect. Among them, 15 cases were repaired with pedicled nasolabial groove flap, 10 cases with modified rhomboid flap, 6 cases with rotatory nasolabial groove flap, 5 cases with V-Y push flap, and 2 cases with double lobe flap.Results:One case had blood transportation obstacle after operation caused by compression and bandaging, 1 case had postoperative infection. Healing of the two cases delayed after treatment, and other patients healed properly. All the flaps survived without facial deformity, and the cosmetic effect was good.Conclusions:The primary repair of the nasal alar defect needs to follow the aesthetic requirements of the nose and face, which varies with diseases and experience of doctors. Flap selection should be individualized to achieve both the purpose of repairing defects and beauty.

Analysis of monitoring results of Mattress-type of sleep monitoring system in elderly patients with OSAHS / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the sleep monitoring feature of the MSMS in elderly patients with OSAHS.@*METHOD@#One hundred and ninety patients diagnosed with OSAHS were divided into elderly group and non elderly group according to age, then the results of MSMS were analyzed.@*RESULT@#Majority elderly patients were with mild to moderate OSAHS. The nocturnal mean blood oxygen and the lowest oxygen were higher than non elderly group, coupled with higher percentage of the total oxygen saturation < 90% monitoring time (TS90). There was no significant difference in sleep structure between two groups, but the total sleep time of elderly group is lower than the non elderly group, the difference is statistically significant.@*CONCLUSION@#The elderly patients with OSAHS were less severe in nature, but the nocturnal hypoxia last longer in the elderly group. There is no significant difference in the sleep structure between the two groups. But the total sleep time decrease in elderly group. With smaller interference, the MSMS is closer to the natural sleep stustus of the subjects.

The application of micro-sensitive mattress type sleep monitor in the diagnosis of OSAHS in children / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the result of child-type micro-sensitive mattress sleep monitor on obstructive sleep apnea-hypopnea syndrome in children.@*METHOD@#The PSG and child-type micro-sensitive mattress sleep monitor were synchronously performed on 58 cases of children with OSAHS. The breathing and sleep metrics were compared.@*RESULT@#By PSG monitoring, 41 cases were diagnosed as mild OSAHS, 14 cases were moderate and 3 cases were severe. The results of mattress system monitoring showed mild OSAHS in 37 cases, 16 cases of moderate and severe OSAHS in 5 cases. Seven patients diagnosed as mild OSAHS monitored by PSG were classified as moderate by mattress system monitoring; three cases diagnosed as mild OSAHS by mattress system monitoring system were diagnosed as moderate by PSG. Among 14 cases of children diagnosed as moderate by PSG, three cases were diagnosed as mild by mattress system monitor and two cases as severe. Children diagnosed as severe by PSG got the same result by mattress system monitor. Two kinds of sleep monitoring methods were compared and there were no statistically significant difference in AHI (t = 2.316, P > 0.05), deep and shallow sleep constituent ratio (t = 2.280, t = 2.388, PF > 0.05). while there was significant difference in REM period Sleep constituent ratio (t = 3.135, P < 0.01).@*CONCLUSION@#Child-type micro-sensitive mattress is in good agreement with the PSG for diagnosing OSAHS in children, which can be used as a monitoring method in clinical work.

Demonstration of the maxillary mucosa restoration after operation to the nasal fungal sinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#This paper aims to demonstrate the maxillary mucosa restoration after operation to the nasal fungal sinusitis.@*METHOD@#Observation by microscopic, transmission electron microscopic and scanning electron microscopic was done to the same parts in the maxillary mucosa 3-4 months before and after the endoscopic sinus surgery in the 24 cases of the nasal fungal sinusitis during 2003-2005.@*RESULT@#Before the operation, all the cases demonstrated epithelia shedding, proliferation, squamous metaplasia, glandular and fibrous tissue proliferation and lymphocytes infiltration. The microtubule was abnormal and mitochondria diminished, 3-4 months after operation, the cavity was clear and smooth and the epithelia complete. The cilia average increased and the cilia lined in the same direction. The structure of microtubules was clear. The mitochondria was elongated and dense.@*CONCLUSION@#There was no significant difference in the damage on ultramicrostructure of the maxillary mucosa between the chronic nasal sinusitis and chronic nasal fungal sinusitis. It is crucial in the successful recovery that the operation gives a thorough clean to the fungal clot and sinus aeration, and that good cleaning and sinus aeration are maintained after the operation. The ultramicrostructure restoration and the function recovery of mucosa will be achieved after careful cleaning for 3-4 months after operation.

Demonstration of the maxillary mucosa restoration after operation to the nasal fungal sinusitis / 临床耳鼻咽喉头颈外科杂志

Objective:This paper aims to demonstrate the maxillary mucosa restoration after operation to the nasal fungal sinusitis. Methods Observation by microscopic, transmission electron microscopic and scanning electron microscopic was done to the same parts in the maxillary mucosa 3-4 months before and after the endoscopic sinus surgery in the 24 cases of the nasal fungal sinusitis during 2003-2005. Result: Before the operation, all the cases demonstrated epithelia shedding, proliferation, squamous metaplasia, glandular and fibrous tissue proliferation and lymphocytes infiltration. The microtubule was abnormal and mitochondria diminished,3-4 months after operation, the cavity was clear and smooth and the epithelia complete. The cilia average increased and the cilia lined in the same direction. The structure of microtubules was clear. The mitochondria was elongated and dense. Conclusion: There was no significant difference in the damage on ultramicrostructure of the maxillary mucosa between the chronic nasal sinusitis and chronic nasal fungal sinusitis. It is crucial in the successful recovery that the operation gives a thorough clean to the fungal clot and sinus aeration, and that good cleaning and sinus aeration are maintained after the operation. The ultramicrostructure restoration and the function recovery of mucosa will be achieved after careful cleaning for 3-4 months after operation.