The outcome of transnasal endoscopic total maxillectomy in the treatment of sinonasal adenoid cystic carcinoma / 临床耳鼻咽喉头颈外科杂志

Objective:To assess the prognosis of sinonasal adenoid cystic carcinoma with hard palatine invasion treated by transnasal endoscopic total maxillectomy. Methods:Clinical data of twenty-six patients with sinonasal adenoid cystic carcinoma invading hard palatine treated by transnasal endoscopic total maxillectomy between May 2014 and December 2020 was analyzed retrospectively. Survival rate, local recurrence and distant metastasis were analyzed using Kaplan-Meier method. Cox regression was used to investigate the prognosis factors. Masticatory function after maxillectomy has also been assessed using the questionnaire of patients' satisfaction about masticatory function. Results:Margins in 8 patients（30%） were positive. The median time of follow-up was 38 months（6 to 85 months）. Twenty-five patients recurred. Four patients died of distant metastasis. The 5-year overall survival rate and relapse-free survival rate was 79.5% and 89.1%, respectively. Independent predictors of outcome on multivariate analysis were positive margin（P=0.018）, recurrence（P=0.006） and distant metastasis（P=0.04）. Conclusion:Transnasal endoscopic total maxillectomy could be performed for the treatment of the sinonasal adenoid cystic carcinoma with hard palatine invasion. Positive margin, local recurrence and distant metastasis were important predictors for patients' prognosis.

Establishment of Endoscopic Surgical Innovative System of Recurrent Nasopharyngeal Carcinoma / 肿瘤防治研究

Nasopharyngeal carcinoma (NPC) is a common malignant tumor in China. Radiotherapy is the first-line treatment. After appropriate radiotherapy, about 5%-15% patients experience recurrence. In view of the poor efficacy and high incidence of severe late toxicities associated with re-irradiation, salvage surgery by the transnasal endoscopic approach is recommended for recurrent NPC (rNPC). Compared with re-irradiation, endoscopic surgery can better prolong survival, improve the quality of life, and reduce complications and medical expenses of patients with rNPC. However, the complexity of the nasopharyngeal skull base enhances the difficulty and risk of surgery. Expanding the boundary of surgical resection remains a clinical challenge for otolaryngologists. In this regard, to help more advanced patients with rNPC, the surgical innovative system of NPC needs to be established by multi-disciplinary cooperation, involving skull base anatomy-based investigation, appropriate administration of the internal carotid artery (ICA), repair of skull base defect, and establishment of various types of endoscopic endonasal nasopharyngectomy.

Fuzhengzhiqiu Granules' effect on ICAM-1 and VCAM-1 expression in nasal mucosa of experimental allergic rhinitis / 中成药

Objective: To investigate Fuzhengzhiqiu Granules' effect on ICAM-1(Intercellular adhesion molecule-1) and VCAM-1(Vascular cell adhesion molecule-1) expression in nasal mucosa of experimental allergic rhinitis. Methods: SD rats (n=64) were immunized by intraperitoneal injection of 200?g Ovalbumin (OVA) (1ml OVA-Al[OH] 3-saline suspension) on 1st, 2ed and eleven day. Normal control group rats A (n=16) were treated with the same methods except injecting OVA. 19th day, 0.1 ml of saline containing 10 mg of OVA was instilled into nasal cavity for 7 consecutive days. Normal control group followed by intranasal administration only with saline. The rats challenged into allergic rhinitis (n=64) were randomly divided into four groups: allergic rhinitis model group B (n=16); Fu zhengzhiqiu Granules treated group C (n=16); Fu zhengzhiqiu Granules treated group D (n=16, three times dosage used in group C); Xinqin Granules treated group E (n=16). All animals were treated for 15 days. The nasal mucosa of them were studied by immunohistochemical staining to observe the ICAM-1 and VCAM-1 expression. Results: Animal model of allergic rhinitis was established by using ovalbumin intraperitoneal immunization and nasal challenge. The number of positive immunoreactive cells (ICAM-1 and VCAM-1) was increased significantly in all the groups compared with normal controls. VCAM-1 expression was inhibited by giving with Fuzhengzhiqiu Granules (especially in group D) and Xinqin Granules (P0.05). Conclusion: Fuzhengzhiqiu Granules can decrease the expression of VCAM-1 in nasal mucosa of experimental allergic rhinitis, but no effect on ICAM-1.