ABSTRACT
Objective @# investigate the correlation between the ossification of the styloid hyoid ligament and Bell’s facial paralysis and provide a reference for clinical diagnosis and treatment.@* Methods@# A case of ossification of the bilateral stylohyoid ligament with Bell's facial palsy caused by ossification of the bilateral stylohyoid ligament was diagnosed by clinical manifestations, differential diagnosis and imaging examination. The surgical plan was determined, and combined surgical resection of the ossified area of the styloid hyoid ligament and the greater horn of the hyoid was performed. Postoperative cefoxitin sodium anti-inflammatory treatment, methylprednisolone hormone treatment, acyclovir antiviral treatment, mecobalamin nutritional neurotherapy, and the relevant literature were analyzed. @* Results@# The patient experienced pain when swallowing before surgery, disappearance of right frontal ridges, incomplete eyelid closure, and ptosis of mouth corners. An MRI scan of the brain excluded intracranial space-occupying lesions and resulted in the diagnosis of Bell’s facial paralysis. High-resolution CT of the styloid process confirmed ossification of the styloid hyoid ligament. Styloid process shortening and partial hyoid resection were performed under general anesthesia. Half a month after discharge, the symptoms of sore throat and pain in swallowing disappeared, facial nerve function recovered well, right eyelid closure function recovered well, and right mouth droop improved. The facial nerve function basically returned to normal after 1 month of follow-up. A review of the relevant literature showed that ossification of the stylohyoid ligament to form pseudojoint dilation can locally stimulate the peripheral facial nerve and lead to facial paralysis symptoms. @*Conclusion@# Ossification of the styloid hyoid ligament is usually characterized by pharyngeal pain, which can be confirmed by imaging examination. Ossification of the styloid hyoid ligament with facial paralysis is rare in the clinic, so it is necessary to make a clear diagnosis and treat the symptoms.
ABSTRACT
Tuberculous peritonitis(TBP)is currently one of the common manifestations of extrapulmonary tuberculosis.Due to the atypical clinical features,diverse types of diseases to be distinguished,and limited detection methods,TBP is difficult to be diagnosed and the fatality caused by delayed diagnosis increases significantly.We studied the current research status of TBP and found that T cells spot test,abdominal CT,and laparoscopic biopsy were of high diagnostic value for TBP.However,the application of ascites Xpert-MTB/RIF-ultra assay,ascites ADA,and whole-body positron emission tomography/computed tomography remained to be studied.Serum CA125 helps to judge the efficacy of anti-tuberculosis treatment.
Subject(s)
Humans , Ascites , Biopsy , Mycobacterium tuberculosis , Peritonitis, Tuberculous/diagnosis , Sensitivity and Specificity , Tuberculosis/diagnosisABSTRACT
Primary hyperparathyroidism (PHPT) with negative or inconsistent imaging is a significant clinical problem. Surgery is the best chance in curing PHPT. Preoperative imaging is performed for lesion localization to help selecting the proper operative approaches. However,negative or inconsistent imaging could not exclude the diagnosis of PHPT and should not be ruled out the decision of operation. Therefore, for PHPT patients who had indication for surgery but with negative or inconsistent imaging result(s), it is better to transfer the patient to experienced center and surgeons for a proper surgical treatment.
ABSTRACT
@#AIM: To investigate the clinical characteristics and follow-up of 191 patients with lacrimal glandoccupying lesions. <p>METHODS: We selected 191 patients(221 eyes)with lacrimal gland occupancy from January 2011 to August 2015. All patients underwent lacrimal gland tumor removal and were followed up for 1a. <p>RESULTS: In the 191 patients(221 eyes), 44 were male(49 eyes)and 147 were female(172 eyes). There were inflammatory lesions in 171 eyes, constituted by IgG<sub>4</sub> sclerosing dacryocystitis 66 eyes, 27 eyes of chronic lacrimal gland, lacrimal gland prolapse with inflammatory enlargement 54 eyes, Grave's disease in 24 eyes; 16 eyes of lymphoid hyperplastic lesions, constituted by malignant lymphoma in 6 eyes, benign lymphoid hyperplasia in 10 eyes; epithelial lesions in 34 eyes, constituted by pleomorphic adenoma in 26 eyes, 2 eyes of pleomorphic adenocarcinoma, adenoid cystic carcinoma in 3 eyes, 3 eyes of adenocarcinoma. Lacrimal glandoccupying lesions with IgG<sub>4</sub> sclerosing dacryocystitis, lacrimal gland prolapse associated with inflammatory enlargement were the most common, of which 159 eyes of Han, Uighur 36 eyes, Kazak 16 eyes, 10 eyes of Mongolian. After surgery, mainly symptoms were dry eye, crying with no tears, with bilateral lacrimal gland removed significantly, but the local use of artificial tears can ease those symptoms with no serious adverse reactions. <p>CONCLUSION: History and imaging characteristics of lacrimal gland-occupying lesions give a great help to the diagnosis and differential diagnosis. In Xinjiang region, lacrimal gland, with non-epithelial lesions is the most common, followed by epithelial lesions, occurred in the Han, Uighur patients, and rare occurred in other ethnic. Dry eye after surgery and crying with no tears are the main symptoms. Patients with short course of disease and dry eye tend to delay the removal of patients.