Analysis of prognostic factors in endoscopic surgery for juvenile nasopharyngeal angiofibroma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Analyzing the prognostic factors in endoscopic surgery of juvenile nasopharyngeal angiofibromas (JNA).@*METHOD@#Forty-seven records of JNA, treated with the endoscopic, from 2002 to 2008 were reviewed retrospectively. Previous surgery in other hospitals, sites involved, whether selective embolization was performed before surgery, feeding vessels, operative techniques and follow-up results were recorded. Evaluated factors include previous surgery for resection of JNA, vascular supply from carotid artery, surgery after selective embolization, involvement of cavernous bone in the root of pterygoid process, greater wing of sphenoid bone, interpterygoid fossa, infratemporal fossa and orbit. Chi-square test was used.@*RESULT@#Operations were done under general anesthesia. The follow-up time was 12 to 87 month (median 35 month). During follow up, six patients presented recurrent lesions. Chi-square test showed that deep invasion of the cavernous bone in the root of pterygoid process was related to recurrence (P<0.05). There was no statistically significant difference between other factors and recurrence. Imaging examination showed that recurrent tumor was around the root of pterygoid process.@*CONCLUSION@#Deep invasion of the cavernous bone in the root of pterygoid process which was related to recurrence deserve close attention before and after endoscopic surgery.

Modified intranasal endoscopic dacryocystorhino-stomy / 中国耳鼻咽喉头颈外科

OBJECTIVE To present the modified intranasal endoscopic dacryocystorhinostomy (MIEDCR) and the clinical results. To discuss the modified operative technique and its purpose. METHODS A total of 31 cases (35 eyes) with chronic dacryocystitis who underwent MIEDCR were included in this study. There were 27 female and 4 male. The age was ranged from 9 to 70 years (mean 31 years). The preoperative dacryocystography was taken in all cases. The follow up time was 6 to 20 months. RESULTS Among the 31 cases with chronic dacyocystitis, 4 patients suffered bilateral chronic dacyocystitis. Dacryocystitis related to nasal endoscopic surgery was found in 2 cases (2 eyes). Four cases (5 eyes) had prior laser lacrimal duct surgery. Two patients had external dacrypcystorhinotomy experience. 34 MIEDCR procedures (97.1 %) were successful. Twenty eight patients (32 eyes) were free of their symptoms and kept stoma patency. The shift of mucosal flap was found in one case when Merocel was removed. The rhinostomy of another 2 cases were closed due to mucosal scar and one of them received revision surgery. There were no operative complications. CONCLUSION The preserved nasal mucosal flap which was replaced over the denuded bone would avoid scar formation and hyperostosis and is benefit to gain a satisfied and good clinical effects of dacryocystorhinostomy.