Diagnosis and treatment of serious adult airway obstruction / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the diagnosis and treatment of serious adult airway obstruction.@*METHOD@#Eighty six adult cases admitted to our hospital for serious airway obstruction from 1995 to 2006, were analyzed retrospectively.@*RESULT@#Among the 86 cases, 34 cases (39.5%) had inflammatory diseases, 32 cases (37.2%) had neoplastic diseases and 9 cases (10.5%) had traumatic diseases. In addition, 3 cases of laryngeal spasm, 6 cases of laryngeal stricture, 2 cases of bilateral laryngeal paralysis and 1 case of asphyxia with aspiration were also include in this study. The patients who had laryngeal or tracheal obstruction were 60 cases (69.8%) and 13 cases (15.1%). In addition, 46 cases (53.5%) and 4 cases (4.7%) had tracheotomy or endotracheal intubation. Twenty six cases were only adopted medical treatment to relieve dyspnea. The final diagnosis of the 86 cases was made and the serious airway obstruction was was relieved within 2 hours. While 14 cases (16.3%) had serious complications and 6 cases (6.9%) had operative complications occurred. One cases (0.2%) died.@*CONCLUSION@#The causes of serious adult airway obstruction could be complicated, the site and character of obstruction would change constantly. Quick diagnosis, timely removal of the obstruction should be critical factors to improve curative effect.

Resection of invasive head and neck neoplasms involving skull base / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the operative methods of invasive head and neck neoplasms involving skull base.@*METHOD@#Thirty-two cases with invasive head and neck neoplasms involving anterior and lateral skull base, from 1997 to 2005, were treated with surgical resection. Nine surgical approaches including endoscopic transnasal approach for five cases, combined craniofacial approach for three cases, maxillary resection approach for 15 cases, transpalatal approach for one case, transmandibular approach for one case, lateral neck-mandibular incision approach for two cases, combined retroauricular and neck approach for one case, frontotemporal approach for two cases, and facial translocation approach for two cases were used to resect the tumors.@*RESULT@#Four cases with nasal sinus mucocele were only applied drainage and one case with chordoma was subtotally resected. The tumors of the rest 27 cases were totally removed. Although one case complicated with cerebrospinal fluid leak and recovered within one week, no one died from the operation and no serious cranium-cerebrum complication occurred. Eight cases with benign tumor were followed up for six months to eight years without recurrence and no one died. For 24 cases with malignant tumor, survival rates of three and five years were 63.2% (12/19), 41.7% (5/12) respectively.@*CONCLUSION@#Surgical approach must be designed according to the pathological change's characters, site and invasive range. Favorable curative effect could be achieved by resecting tumors totally as possible, protecting important constitutions, and adopting proper reparative techniques.

Expression of CD44s and CD44v6 in laryngeal squamous cell carcinoma and their significance / 临床耳鼻咽喉头颈外科杂志

Objective: To study the correlation between the expression of CD44s, CD44v6 and theclinicopathological characters of laryngeal squamous cell carcinoma (LSCC) so as to analyze the role of them inoccurrence and progression of LSCC. Method:Expression of CD44 and CD44v6 in 46 cases of LSCC and 20 casesof adjacent normal tissues was inspected with immunohistochemical SP method. Result:The expression of CD44sincreased significantly in lymphnode metastasis group (94.4％) and stage Ⅲ～Ⅳ group (96.2％),but decreasedin non-lymphnode metastasis group (67.9％) and stage Ⅰ～Ⅱ group (55.0％). The expression of CD44v6 waslower (21.7％),which wasn′t associated with any clinicopathological characters. Conclusion:The role of CD44and CD44v6 in carcinoma maybe dependent on the species,type of carcinoma, and the expression of CD44s maybe a biologic marker to evaluate metastasis of LSCC.