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OBJECTIVE To discuss the clinical features of primary lateral recess cysts of the sphenoid sinus,and to study the therapeutic effect of the endoscopic surgery.METHODS Nine patients with primary lateral recess cysts of the sphenoid sinus received endoscopic surgery from 2007 to 2015.Clinical data of the disease was analyzed retrospectively.Seven cases complained of cheek numbness as the chief complaint and 2 cases with progressive vision loss as the chief complaint.There were no obvious positive signs in head and facial regions.All cases were underwent marsupialization of the cysts via sphenoid sinus with nasal endoscope under general anesthesia.RESULTS All the cases had no intraoperative and postoperative complications,and the symptoms were disappeared after operation.No recurrence was found during follow-up of 6 to 24 months.The cavity of the cysts had permanent drainage to sphenoid sinus after operation in all the patients.CONCLUSION 1.Primary lateral recess cysts of the sphenoid sinus had unique symptoms and imaging characteristics.2.The marsupialization of the cysts via sphenoid sinus with nasal endoscope under general anesthesia was a safe,effective and minimally invasive method to management of the primary lateral recess cysts of the sphenoid sinus.
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Objective To explore the efficacy of reserving thyroid cartilage combined with thyroid perichondrium flap to repair the defect of frontal-lateral window partial laryngectomy for T1b glottic cancinoma with anterior commissure involved.Methods From our hospital 22 cases diagnosed as T1b glottic cancer with anterior commissure invaded were treated with frontal-lateral window partial laryngectomy and were repaired by reserving thyroid cartilage combined with flap of thyroid perichondrium.All the patients were followed up for five years.The functions of respiratory and swallowing,voice rehabilitation,ratios of recurrence and survival were observed.Results All the patients succeeded in removing tracheal cannula.The decannulation rate was100％ and the aspiration rate was 0％.The voice functions in patients with postoperative classification (G) were higher than that of preoperative accounted for 86.4％ (19/22),and the same preoperative accounted for 13.6％ (3/22).There were 2 cases with tumor recurrence,one cases with recurrence in situ and one case with cervical lymph node metastasis.The recurrence rate was 9.1％ (2/22) and the 5 year survival rate was 95.5％ (21/22).Conclusion Frontal-lateral window partial laryngectomy reserving thyroid cartilage combined with thyroid perichondrium flap,is suitable for T1b glottic cancinoma invading anterior commissure.It can preserve the laryngeal framework and function relatively integrated with rare laryngeal stenosis and stabble repaired tissue.It also can effectively improve the sound quality and is worthy of clinical promotion.
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[ABSTRACT]OBJECTIVETo investigate the treatment choice and curative effect of stage III external auditory canal cholesteatoma (EACC) with different degrees of damage to the posterior wall of external auditory canal and mastoid.METHODS44 patients (45 ears) diagnosed with III type external auditory canal cholesteatoma and treated with different surgeries were collected: 27 ears with damages of mastoid which did not involve tympanic antrum (group A) underwent simple mastoid repair+external auditory canal plasty+conchoplasty (in necessity). 18 ears with damages of mastoid which involve the tympanic antrum (group B) underwent mastoidectomy+mastoid filling+external auditory canal plasty+conchoplasty. RESULTSAll patients were followed up for 1 to 2 years postoperatively. There was no recurrence of cholesteatoma, no external auditory canal collapse, stricture or atresia,and hearing improved to different degrees. The postoperative dry ear rate of group A and group B was 100% and 94.4% respectively. The mean duration of dry ear in group A and B was (12.1±2.3) and (28.1±3.5) days respectively. The cases with smooth external auditory canal and good self-purification in group Aand B accounted for 100% and 88.9%respectively.CONCLUSIONType III external auditory canal cholesteatoma can be treated with different surgical methods according to different damages of mastoid. The cases in which damages of mastoid did not involve tympanic antrum can be treated with simple mastoid repair+external auditory canal plasty+conchoplasty (in necessity). The cases in which damages of mastoid involved tympanic antrum can be treated with mastoidectomy+mastoid filling+external auditory canal plasty+conchoplasty.
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OBJECTIVE@#To explore the clinical manifestations and treatments of retro-esophageal space abscess.@*METHOD@#The clinical data of 27 cases with retro-esophageal space abscess were analyzed retrospectively. Twenty-one cases (77. 78%) were secondary to acute injury of esophageal meatus caused by foreign bodies. 2 cases (7. 41%)were secondary to old foreign body infection in retro-esophageal space, 3 cases (11. 11%) after secondary to pharyngeal abscess, and 1 case (3. 70%) was unknown to etiology. All patients were confirmed by sectional medicalimageology. Six cases(Conservation group, C group) were treated conservatively and 6 cases (Oropharyngeal incision group, OI group) were performed with oropharyngeal incision drainage. 15 cases(Extra-neck incision group, ENI group)were performed with extra-neck incision and vacuum sealing drainage.@*RESULT@#In C group, 6 cases were cured with conservative therapy and the average hospital stay was 15. 6 days. In OI group, 5 cases were healed with oropharyngeal drainage but aspiration pneumonia complicated with septic shock occurred in 2 cases, and 1 case dead from septic shock secondary to mediastinum and lung abscess. The average hospital stay was 18. 8 days. In ENI group, 15 patients were cured with extra-neck drainage without complication and the average hospital stay was 9. 5 days.@*CONCLUSION@#The main causes of retro-esophageal space abscess are foreign body injury of upper esophagus and remnant of retro-esophageal space. Sectional medicalimageology can be of important value of diagnosis and treatment for displaying the retro-esophageal space abscess and other deep cervical fascia space sufficiently. Incision and vacuum sealing drainage via extra-neck is an effective therapy while oropharyngeal drainage is less effective and is not advocated as a primary treatment because of aspiration pneumonia complication . Conservative cure is a choice for patients without dyspnoea and background diseases, and it is necessary to recognize and treat severe complications early.
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Humanos , Absceso , Terapéutica , Drenaje , Esófago , Cuerpos Extraños , Cuello , Enfermedades Faríngeas , Estudios RetrospectivosRESUMEN
Objective To investigate the clinical effect of myringoplasty with double flaps in treatment of large tympanic membrane perforaton.Methods Ninety-five patients (112 ears) with large tympanic membrane perforation were enrolled in this study,48 patients (54 ears) were performed myringoplasty with double flaps (double flaps method group) and 50 patients (58 ears) were performed myringoplasty with underlay method (underlay method group).The air conduction (AC) and air bone gap (ABG) were measured before operation and 6 months after operation.The clinical efficacy of two groups was compared.Results The successful rate in double flaps method group was 96.3％ (52/54) and 91.4％ (53/58) in underlay method group,there was no significant difference (P ＞0.05).The effective rate in double flaps method group was 92.6％ (50/54) and 77.6％ (45/58) in underlay method group,there was significant difference (P ＜ 0.01).Conclusions Myringoplasty with double flaps in treatment of large tympanic membrane perforation can effectively mould tympanic membrane and improve hearing.The operation is worthy of spreading.