Surgical treatment to facial nerve paralysis of different pathogeny / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the surgical treatment to facial nerve paralysis of different pathogeny.@*METHOD@#Thirty-seven patients were reviewed, including Bell's Palsy (5 patients), temporal bone fracture (20 patients), media otitis (cholesteatoma) (4 patients), facial neuroma and cranio-maxillo-facial operation trauma (8 patients). All the patients were treated by different surgical methods according different pathogeny.@*RESULT@#The mean percentage facial function improvement (House-Brackmann Grade I-II) was 80% to Bell's Palsy and temporal bone fracture, 100% to media otitis (cholesteatoma). Facial function of three patients improved from House-Brackmann Grade IV to III, two patients had no obvious improvement about facial neuroma; three patients improved from Grade V to III, one improved to IV about cranio-maxillo-facial operation trauma.@*CONCLUSION@#Patients of facial nerve paralysis got better curative effect if treated by proper surgical therapy according different pathogeny.

Characteristics of invasive damages of nerve system in sphenoid-sinus-o-tumoropathy and transnasal endoscopic surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the relationships between the sphenoid-sinus-o-tumoropathy and local anatomy, as well as the characteristics of invasive damages of nerve system in sphenoid-sinus-o-tumoropathy, and emphasize that it is crucial of early diagnosis and surgery for sphenoid-sinus-o-tumoropathy.@*METHOD@#Retrospective analysis of the characteristics of invasive damages of nerve system in 13 patients with sphenoid-sinus-o-tumoropathy, and follow-up the outcomes of nerve system after transnasal endoscopic surgery.@*RESULT@#1) The majority clinical manifestations of invasive damages in nerve system are cranial nerves, there are 9 cases optic nerve, 7 cases oculomotorius nerve, 4 cases trochlear nerve, 4 cases abducent nerve and 1 cases trigeminal nerve have been found damage at different levels in this group, and the secondly are 3 cases dysfunction of pituitary and 2 cases central nerve damage. 2) The improvement of invasive damages in nerve system after transnasal endoscopic surgery are as follow: at the day of operation or the next day, there are 4 cases to be reported that the symptoms of headache and eyes relieve very well; during 3 to 7 days after operation there are 9 cases to be reported that the symptoms of headache and eyes relieve or disappear significantly; 2 weeks after operation, there are 8 cases to be reported that the optical sights recovery at different levels, and there are many symptoms such as headache (9 cases), visual diplopia (1 cases), ptosis (2 cases), fixation of eyeball (1 cases), exophthalmoptosis (2 cases), face pain (2 cases), orbital paralysis (2 cases) disappeared completely. No complications of cerebrospinal fluid rhinorrhea, brain edema and hemorrhage to be found during the period of operation and follow-up.@*CONCLUSION@#The majority clinical characteristics of invasive damage in nerve system with sphenoid-sinus-o-tumoropathy are cranial nerve manifestations, and the second manifestation is dysfunction of pituitary. Transnasal endoscopic surgery could inhibit the invasive damages in cranial nerves of sphenoid-sinus-o-tumoropathic patients effectively.

Relative factors analysis including carcinoma marker, molecular margin and clinical factors on laryngeal carcinoma recurrence / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the factors of laryngeal carcinoma recurrence, 103 patients of laryngeal carcinoma were analyzed retrospectively on carcinoma marker, molecular margin and clinical factors with univariate analysis and multivariate analysis.@*METHOD@#CyclinD1, p27, p53 and eIF4E in primary site and surgery margins were detected in laryngeal carcinoma recurrence group and unrecurrence group with immunohistochemical staining to explore the significance of CyclinD1, p27, p53 and eIF4E on laryngeal carcinoma recurrence; The clinical data of 103 patients of laryngeal carcinoma were analyzed retrospectively to investigate the clinical factors of laryngeal carcinoma recurrence; At last above three factors were analyzed with multivariate analysis.@*RESULT@#There was significant difference between laryngeal carcinoma recurrence group and unrecurrence group about CyclinD1, p27 and p53 in laryngeal primary site; There was no significant difference between laryngeal carcinoma recurrence group and unrecurrence group about eIF4E. There was significant difference between laryngeal carcinoma recurrence group and unrecurrence group about CyclinD1, p27, p53 and eIF4E in surgery margins. Laryngeal carcinoma recurrence after surgery was related with carcinoma site, T stage, node metastasis, laryngeal carcinoma pathology and operative method; However, it was not related with age, sex and postoperative irradiation therapy with univariate analysis. Laryngeal carcinoma recurrence after surgery was related with T stage, node metastasis, laryngeal carcinoma pathology and operative method with logistic multivariate analysis. At last, laryngeal carcinoma recurrence after surgery was related with T stage, node metastasis, laryngeal carcinoma pathology and positive molecular margins with logistic multivariate analysis.@*CONCLUSION@#The factors of laryngeal carcinoma recurrence is comprehensive. T stage, node metastasis,laryngeal carcinoma pathology and laryngeal carcinoma positive molecular margins were related with laryngeal carcinoma recurrence. Positive molecular margins were more reliable.

Biopsy for middle skull base neoplasms under nasal endoscope / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the significance,indication,operation experience and complication of biopsy for middle skull base neoplasms under nasal endoscope.METHODS A total of 48 patients with middle skull base neoplasms underwent biopsy under nasal endoscope with local or general anesthesia.RESULTS Biopsy was successfully done in 95.8%patients.Two patients failed to the procedure because of bleeding.Forty two patients were diagnosed pathologically through the biopsy at the first time,and 4 patients were diagnosed through the biopsy at the second time.The positive rates of the biopsy near and in the lesions were 82.6%and 97.8%respectively. The positive rates were significantly different between those two different biopsy sites(P=0.02).Blood loss was less than 50ml in 85.4%patients.Only one patient had the complication of leakage of cerebrospinal fluid.CONCLUSION Biopsy of middle skull base neoplasms under nasal endoscope can identify the pathological nature of the lesions with minimal invasion and less complication,and it is a reliable method.The pathological positive rate is relative to the sites of the biopsy.Serial biopsies can increase the positive rate.