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OBJECTIVE To evaluate the clinical feature and surgical treatment of large nasopharyngeal angiofibromas with intracranial orcavernous sinus extension.METHODS A total of 16 male patients were collected with a age ranged from 11 to 35 years(mean,17.21 years).All patients underwent resection of nasopharyngeal angiofibromas with intracranial or cavernous sinus extension.The procedure included lateral rhinotomy,craniofacial combined approach,median labiomandibulotomy combined with a trans-palatal,transmaxillary approach and middle face degloving approach.RESULTS Sixteen cases received 28 procedures.Seven patients had no recurrence but 9 patients had recurrence at least once.Twenty eight procedures include 11 times lateral rhinotomy,6 times craniofacial combined approach,2 times frontotemporal approach,4 times transpalatal approach,2 transmaxillary approach,1 median labiomandibulotomy combined with a trans-palatal and 2 times middle face degloving approaches.CONCLUSION Radical operative resection is the main treatment method for nasopharyngeal angiofibroma with intracranial or cavernous sinus extension.The first operation recurrence rate is 8/15(53.0%) and sphenoid tumor residual may often be ignored in the operation and it is the main site of tumor recurrence.Craniofacial,median labiomandibulotomy combined with a trans-palatal and middle face degloving approaches were the best choices for large nasopharyngeal angio fi broma with intracranial or cavernous sinus extension.
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To illustrate the location of HSP-70 (heat\|shock protein\|70)correlative response in acute stage between middle and inner ear when mammalian middle ear infected by bacteria, and investigate the possibility to cause autoimmune inner ear injure by HSP-70 that induced by otitis media. An animal model of acute otitis media was established by inoculating Klebsiella pneumoniae (K.p) into middle ear of guinea pigs. Animals were sacrificed 1,3,5 and 7days after inoculation.Investigation of the locations of HSP-70 in middle ear mucosa and cochlea structures were detected by immunocytochemical technique .The results showed that light stain of HSP-70 existed in the superficial epithelium cells of normal mucosa and cochlea structures such as stria vascularis, spiral ligament and Corti′s organ.Heavy stain appeared in the same sites in the infected ears . No different positive sites was observed in all animals.Our findings suggested that HSP-70 were expressed in middle ear mucosa and inner ear structures during acute middle ear infective stage.The HSP-70 provide a material base for causing autoimmune inner ear injure during middle ear bacteria infection.
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Objective To compare the alaryngeal speakers'voice acoustic parameters and intra-tracheal pressure when they spoke different vowels.Methods 24 patients after tracheo-esophageal shunt phonation by the anastomosis of the membranous portion of the tracheal section with the anterior wall of esophagus after total laryngectomy and 16 esophageal speakers enrolled in this study. The voice acoustic parameters were measured when they spoke soft /a/ and soft /i/. The intra-tracheal pressure of 20 TE speakers was measured when spoke /a/ and /i/.Results There were no significant differences between vowel /a/ and /i/ in the two alaryngeal speaker group. The pressure of TE speakers after Shang's procedrue for comfortable /i/ was higher than that for /a/, and there was significant difference.Conclusion There were the same clinical meanings in evaluating alaryngeal voice acoustic aspect. when using vowel /a/ and /i/. However when using different vowel, the intrtracheal pressure was different in TE speakers.