Clinical analysis of endoscopic sinus surgery on patients with chronic sinusitis with nasal polyps complicated and asthma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the efficacy of the treatment of endoscopic sinus surgery on patients dignosed as chronic sinusitis with nasal polyps(CRSwNP) complicated and asthma.@*METHOD@#Data of 45 patients with CRSwNP complicated asthma were analyzed retrospectively.@*RESULT@#All cases were followed up for a period of 1 to 3 years after operation. In the 45 cases treated with ESS, 32 cases were cured, 9 cases were improved and 4 cases were inefficient by the treatment. The cure rate was 91.1% (41/45). The asthma symptoms were improved in 16 patients compared to 4 before the surgery.@*CONCLUSION@#With ESS based on combined therapy,it can significantly improve the condition of CRSwNP, asthma symptoms and pulmonary function. Meanwhile, sufficient perioperative period preparation should be made to ensure the safety of the operation.

Clinical analysis of revision endoscopic sinus surgery for recurrent chronic rhinosinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the therapeutic effect of revision endoscopic sinus surgery for recurrent chronic rhinosinusitis.@*METHOD@#Clinical data of 45 cases of recurrent rhinosinusitis treated in our hospital were retrospectively analyzed. Revision endoscopic sinus surgery was performed in all the patients.@*RESULT@#All the patients were followed up for a period of 1 to 2 years after operation. No serious complication occured. The cure rate was 75.6% (34 cases), 8 cases (17.8%) improved, while other 3 cases (6.6%) were of no effect.@*CONCLUSION@#Recurrent rhinosinusitis is closely related with medical treatment before the surgery, adhesion in nasal cavity after the surgery, deviation of nasal septum, treatment of superior turbine and inferior turbine and regular medicament management after the surgery. Revision endoscopic sinus surgery is an effective method for recurrent recurrent rhinosinusitis. The efficacy of revision endoscopic sinus surgery can be greatly improved by reasonable perioperative management, skilled operation and regular follow-up postoperatively.

Clinical analysis of imflammatory myofibroblastic tumor of the nasal cavity and paranasal sinus / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical features, therapeutic methods and therapeutic efficacy of imflammatory myofibroblastic tumor(IMT)of the nasal cavity and paranasal sinuses.@*METHOD@#Clinical data of 14 cases diagnosed as IMT by pathology were retrospectively analyzed. There were 8 males and 6 females,age ranging from 18 to 77 years. 12 cases of them were treated by surgery while 2 cases received postoperative radiotherapy.@*RESULT@#All cases were operated. All the patients were followed up for a period of 1 to 7 years after operation and two cases were proved low grade IMT pathologically. Eight cases survived with no recurrence until the last follow-up and 6 cases relapsed, of which 4 cases died and 2 were alive with tumor.@*CONCLUSION@#IMT of the nasal cavity and paranasal sinuses is very rare. The diagonosis of IMT is based on pathology and immunohistochemistry. Proper diagnosis is essential to avoid mutilating and disfiguring surgical procedures. Radical excision is still the first choice of treatment for IMT of the nasal cavity and paranasal sinuses. Chemotherapy and radiotherapy may not be helpful to prevent recurrence after operation. Due to high recurrence rate, long-term follow up is necessary after operation.

Clinical analysis of sinonasal hemangiopericytoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical features, therapeutic methods and therapeutic effects of sinonasal hemangiopericytoma.</p><p><b>METHODS</b>Clinical data of 6 patients with sinonasal hemangiopericytoma, diagnosed by pathology and immunohistochemistry between January 1990 and December 2012 were analyzed retrospectively. There were 4 males and 2 females, with a median age of 58 years. Clinical manifestation included epistaxis and nasal obstruction. These patients were operated on by nasal endoscopic surgery or endoscope-assisted surgery, of which 2 cases of tumor located in the nasal cavity underwent nasal endoscopic surgery and 4 cases of tumor located in the nasal cavity and sinuses underwent endoscope-assisted surgery.</p><p><b>RESULTS</b>All the patients were followed up for a period of 6 months to 7 years after operation. Two cases recurred and 4 cases didn't recurred. One case recurred 6 months after operation and underwent second operation, with no recurrence by further one year follow-up. Another case recurred 17 months after operation and underwent second operation, with recurrence by further 9 months follow-up. This patient lived with tumor over two years.</p><p><b>CONCLUSIONS</b>Hemangiopericytomas are rarely found in the sinonasal cavity. Nasal endoscopic or endoscope-assisted surgery provides satisfactory effect.</p>

Clinical analysis of endoscopic nasal cavity expansion surgery for treatment of obstructive sleep apnea hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the efficacy of endoscopic nasal cavity expansion surgery on obstructive sleep apnea hypopnea syndrome (OSAHS) and nasal obstruction.@*METHOD@#Clinical data of 48 OSAHS patients with structural abnormality in nasal cavity treated in our department were retrospectively analysed. These patients received endoscopic nasal cavity expansion surgery and were observed for the relief of both subjective and objective symptoms.@*RESULT@#PSG was reexamined 12 months postoperatively. Of all the patients, 29 cases (60.4%) showed complete recovery, 10 cases (20.8%) showed remarkable improvement of the symptoms, 4 cases (8.3%) exhibited curative effect and 5 cases (10.4%) were of no effect, respectively. The symptoms of apnea, hypopnea, LSaO2 and somnolence were significantly improved in all patients,and nasal congestion was obviously relieved. The improvement of snore was not evident.@*CONCLUSION@#Endoscopic nasal cavity expansion surgery is effective and safe for the treatment of OSAHS mainly due to nasal obstruction. Operation should be performed to correct structural abnormality in nasal cavity and adjust symmetric distribution of nasal airflow on both sides in order to maintain normal ventilation function. The procedure is applicable to OSAHS patients accompanied by nasal congestion and upper airway resistance syndrome and personalized adjustment is beneficial for better clinical efficacy according to the condition of different patients.

Clinical analysis of esophageal perforation and neck abscess induced by esophageal foreign body / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the diagnosis and treatment of esophageal perforation and neck abscess induced by esophageal foreign body and to make a better solution for the disease.@*METHOD@#Twenty-four cases with esophageal perforation and neck abscess induced by esophageal foreign body treated in our department were surgery under general anesthesia. The foreign bodies were removed via esophagoscope in 14 cases, thorocomy in 3 eral neck incision in 5; and no foreign bodies were found in 2 cases.@*RESULT@#There were 16 cases complicated by abscess. Among these complications,there were 10 cases of periesophageal abscess,4 cases of neck abscess and 1 case of mediastinal abscess. In 24 patients, 21 cases cured and one died. One case was sent to the department of endocrinology because of hyperglycaemia and two cases were sent to the department of thoracic surgery for further treatment.@*CONCLUSION@#Early diagnosis and treatment is the key to the management of esophageal perforation induced by esophageal foreign body. Thin-section CT has a high value for the diagnosis and differential diagnosis in such patients. Once deep neck abscess is diagnosed, an early abscess surgical drainage, an appropriate antibiotics and a nutrition supporting treatment are effective for the patients.

Endoscopic resection of benign fibro-osseous lesions of naso-sinuses with different surgical choice / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore and discuss the characteristics of benign fibro-osseous lesion of naso-sinuses and the features and indications of different surgical choice with endoscope.@*METHOD@#Fourteen patients with benign fibro-osseous lesion of naso-sinuses were treated through endoscopic surgery, of which 9 cases underwent endonasal endoscopic surgery simply, 2 cases were operated with a superciliary arch incision through endoscope, 1 case underwent endoscopic caldwell-luc' surgery, 1 case was operated with endoscopic surgery through frontal recess of tears, and 1 case was operated with Draf II surgery under endoscope.@*RESULT@#In all of patients, 2 cases relapsed, 2 cases had residual lesions, 4 cases had complications including numbness and scar of incision, no relapse and no complications in other 6 cases.@*CONCLUSION@#Endoscopic resection of benign fibro-osseous lesion of naso-sinuses with different surgical choice was of special advantages, but the exactly indications, relapse rate and complications should be observed and reckoned deeply.

Clinical analysis of surgical approaches and efficacy of benign occupying lesion of unilateral maxillary sinus / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the therapeutic methods and efficacy of benign occupying lesion of unilateral maxillary sinus.@*METHOD@#The clinical data of 84 patients treated with endoscopic surgery from June 2005 to June 2012 were retrospectively analyzed. Among these patients, 39 cases were treated by endoscopic surgery only, 18 cases were treated by endoscopic plus modified Caldwell-Luc technique, 15 cases were treated by endoscopic plus inferior meatus antrostomy approach, and 12 cases were treated by endoscopic anterior lacrimal recess approach. All patients were followed up postoperatively.@*RESULT@#All cases were followed up from 4 months to 7 years. Among them,81 cases had no recurrence,whereas three cases recurred during the follow-up period. All cases were preoperatively diagnosed by CT, MRI or intranasal endoscopy,which were confirmed by pathological examination postoperatively.@*CONCLUSION@#Maxillary cyst and fungal maxillary sinusitis are the major types of benign occupying lesions of maxillary sinus. According to different clinical features of benign occupying lesions of maxillary sinus,different surgical approaches should be adopted. It can not only effectively cure maxillary sinus lesions, but aslo minimize the operation trauma. Endoscopic sinus surgery is the preferred technique for treating benign occupying lesions of maxillary sinus.

Clinical analysis of nasal and laryngeal neuroendocrine carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinicopathological features, therapeutic methods and therapeutic effects of neuroendocrine carcinoma in nasal and laryngeal region.@*METHOD@#Six cases with neuroendocrine carcinoma of the nose and the larynx were analyzed retrospectively. All cases were proved by pathology and immunohistochemistry. One case was treated by only radiotherapy, and five cases by combined treatment (surgery followed by radiotherapy and chemotherapy).@*RESULT@#All the patients were followed up for a period of 11-84 months. Two cases showed recurrence after operation. Three cases occurred cervical lymph node metastasis, of which 2 cases received neck dissection and 1 case received chemotherapy and radiotherapy due to no surgical indications. Three cases occurred local recurrence, cervical lymphadenopathy, liver or lung metastases. Until the last follow up, four patients died of tumor, while two patients lived with no evidence of disease.@*CONCLUSION@#Nasal and laryngeal neuroendocrine carcinoma is composed of a group of different morphology and prognosis lesions. Corrent diagnosis depends on clinical characteristic, electron microscopic and immunohistochemical examination. CT and MRI examination could be helpful to understand the extent of disease and lesion nature. The prognosis and treatment method of neuroendocrine carcinoma were vary with different pathological types. Combined treatment based on surgery should be adopted to the disease.

Clinical analysis of nasal mucosa contact headache / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the efficacy of nasal mucosa contact point headache with the treatment of endoscopic sinus surgery.@*METHOD@#Clinical data of 75 cases with nasal mucosa contact point headache treated in our department from Jan 2008 to Nov 2011 were retrospectively analyzed. These patients were performed with endoscopic sinus surgery.@*RESULT@#All patients were followed up for more than six months. They all achieved significant efficacy and no complications occurred.@*CONCLUSION@#Nasal mucosa contact point headache and primary headache had different clinical features and different treatment. Misdiagnosis were easily made if not being carefully analyzed. Three lines tension relaxing septorhinoplasty combined with nasal bone fracture correction can achieve satisfactory curative effect and can effectively prevent the occurrence of complications. Therefore, it is necessary to strengthen the awareness of this disease. Nasal structure abnormality is the main reason of nasal mucosa contact point headache. The implementation of individualized nasal endoscopic sinus surgery can achieve satisfactory curative effect.

Report of 6 orbital apex syndrome caused by sinus diseases / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the diagnostic and therapeutic methods of orbital apex syndrome caused by sinus diseases and to achieve earlier diagnosis and timely treatment.@*METHOD@#Clinical data of 6 cases in our department from January 2008 to March 2012 were retrospectively analyzed.@*RESULT@#All cases had surgical treatment. All cases were preoperatively diagnosed by CT, MRI or intranasal endoscopy. The postoperative pathology showed 2 cases with fungal sphenoiditis, 2 cases with ethmoid mucocele and 2 cases with sphenoid mucocele.@*CONCLUSION@#Orbital apex syndrome caused by sinus diseases is very rare. The possible causes of misdiagnosis are low incidence of the disease, nonspecific eye symptoms, and unawareness of the doctor, especially ophthalmologist. CT, MRI or intranasal endoscopy can greatly improve the diagnosis of the disease. Endoscopic sinus surgery is a safe and effective method for orbital apex syndrome caused by sinus diseases,which is the primary therapy for the disease.

Clinical analysis of deep neck infection and its relative factors / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the diagnosis and treatment of deep neck infection.@*METHOD@#Clinical data of 45 cases treated in our department from Jan 2003 to Apr 2012 were retrospectively analysed.@*RESULT@#Nineteen cases of deep neck infection in 45 patients without abscess formation were treated with high-dose antibiotics. Performed computed tomography, the other 26 patients were treated by abscess incision and drainage, the wound healed well without complications.@*CONCLUSION@#Early diagnosis and treatment of deep neck infection is very important. Once deep neck abscess is diagnosed, early abscess surgical drainage, appropriate antibiotics and nutrition supporting treatment are effective for deep neck abscess.

Clinicopathological analysis of sinonasal ectopic meningioma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the diagnostic and therapeutic methods of sinonasal ectopic meningioma.@*METHOD@#The clinical data of 8 patients treated in our department from Jan 1990 to Oct 2011 were retrospectively analysed. Among these patients, 5 cases were treated by lateral rhinotomy approach; 2 cases were treated by endoscopic plus modified Caldwell-Luc technique; 1 case was treated by endoscopic plus modified Caldwell-Luc technique. All patients were followed up postoperatively.@*RESULT@#All patients had no complications after operation. All patients were followed up from six months to 22 years. Among them, two cases had recurred 18 months and one year postoperatively. The two cases did not recur after the second operation.@*CONCLUSION@#Although sinonasal ectopic meningioma is difficult to diagnose because of their infrequent occurrence in this ectopic site and of their non-specific clinical appearance. The final diagnosis rests on the histological examination. Immunohistochemical studies are helpful to establish the accurate diagnosis. Prognosis is excellent after complete surgical resection.

Electrophysiologic study of murine spiral ganglion neurons / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the nature of voltage dependent ion channels and basic electrophysiological characteristics of cochlear spiral ganglion neurons of apical and basal turn by patch clamp techniques of whole cell configure on murine spiral ganglion neurons.@*METHOD@#Different voltage dependent ionic currents were recorded with patch clamp techniques of whole cell configure on the condition of different internal electrode solution, blockers and stimulus protocol.@*RESULT@#Inward sodium channel current (I(Na)), hyperpolarization-activated inward cationic current (Ih), outward delay rectification potassium current (I(K)) and outward transient potassium current (I(A)) were recorded ,significant difference of electrophysiological characteristics of I(A) and I(K) was found between apical and basal turns (P < 0.05).@*CONCLUSION@#Various ionic currents are recorded, which shows that spiral ganglion neurons have the base of ionic channels to complete formation,conduction and modulation of action potential for auditory information transduction, the difference of electrophysiological characteristics between apical and basal turns contributes to the course of hearing formation.

Electrophisiologic study of routine spiral ganglion neurons / 临床耳鼻咽喉头颈外科杂志

Objective: To explore the nature of voltage dependent ion channels and basic electrophysiological characteristics of cochlear spiral ganglion neurons of apical and basal turn by patch clamp techniques of whole cell configure on murine spiral ganglion neurons. Method: Different voltage dependent ionic currents were recorded with patch clamp techniques of whole cell configure on the condition of different internal electrode solution,blockers and stimulus protocol. Result: Inward sodium channel current(I_(Na)), hyperpolarization-activated inward cationic current(I_h) ,outward delay rectification potassium current (I_k) and outward transient potassium current (I_A)were recorded , significant difference of electrophysiological characteristics of I_A and I_k was found between apical and basal turns(P＜0.05). Conclusion: Various ionic currents are recorded,which shows that spiral ganglion neurons have the base of ionic channels to complete formation,conduction and modulation of action potential for auditory information transduction, the difference of electrophysiological characteristics between apical and basal turns contributes to the course of hearing formation.