Primary nasopharyngeal tuberculosis presenting as durative aural fullness: one case report and literature review / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the clinical features, diagnosis and treatments of primary nasopharyngeal tuberculosis.@*METHOD@#A case report was presented, and meanwhile etiopathogenesis and differential diagnosis were also reviewed.@*RESULT@#A biopsy was taken and the histopathological examination showed tuberculosis granuloma with caseous necrosis. After anti-tuberculosis therapy, the symptoms disappeared.@*CONCLUSION@#Not only otologic disorders but also nasopharyngeal diseases need to be considered when aural fullness exists. More importantly, primary nasopharyngeal tuberculosis should be taken as one of the differential diagnosis.

Clinical analysis on 15 cases with cystic lymphangiomas located in head and neck in children / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the diagnosis and effective treatment of cystic lymphangiomas located in head and neck in children.@*METHOD@#Fifteen cystic lymphangiomas,diagnosed with pathological evidence, located in head and neck in children were retrospectively analyzed including clinical characteristics, diagnosis, treatment and follow-up data.@*RESULT@#CT and ultrasonography were used to evaluate the size, shape and extent of lymphangiomas in all patients. All patients were treated with surgery. Complete resection was performed in 14 cases, and subtotal resection in one case. Two post-operative complications were found,one was paralyses of mandibular branch of facial nerve, another was Horners syndrome. Tracheotomy operation was done in one case,and the tracheal cannula was taken away before discharged from hospital. Fourteen patients were followed up. There was no recurrence during the follow-up from 6 months to 8 years, while one case who suffered from Horner's syndrome after operation was not cured.@*CONCLUSION@#CT and ultrasonography are effective to diagnose cystic lymphangiomas and evaluate the security of clinical treatment. Total or subtotal resection is effective to treat cystic lymphangiomas.

Analysis of clinical characteristics and treatment outcome of bilateral and unilateral sudden sensorineural hearing loss / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the clinical characteristics and treatment of bilateral and unilateral sudden sensorineural hearing loss (SSHL) and figure out the differences between bi-and unilateral sudden sensorineural hearing loss, and further improve the diagnosis and treatment of SSHL.@*METHOD@#The retrospective study was based on 334 patients with SSHL (315 with uni-SSHL versus 18 with bi-SSHL) and all of the patients were in-patients.@*RESULT@#The incidence of bi-SSHL was 5.4% of patients with SSHL. There was no significant difference on the clinical features such as age, gender, interval from onset of symptoms to seeing doctors and associated symptoms between bi-and unilateral SSHL. 27.8% of the patients with bi-SSHL had preexisting diabetes mellitus, which was significantly higher than the rate of the uni-SSHL (9.8%, P<0.05). Hearing loss was more profound in the uni-SSHL ones, however, the hearing improvements were better than their counterparts. The overall effective rate of the two groups was 58.4% and 13.9% respectively. Earlier diagnosis and treatment with steroids would have a good prognosis.@*CONCLUSION@#Unilateral SSHL is more common than bilateral SSHL. Bilateral SSHL occurs more common with preexisting diabetes mellitus and has worse prognosis compared to unilateral SSHL. The earlier steroid treatment the better prognosis.

Applied anatomy of operation through posterior tympanum approach / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To provide the anatomic data for operation on the middle ear through the observation and measurement of related anatomic structure.@*METHOD@#Forty human temporal bones of 20 voluntary bone donors were dissected, relative anatomical data of operation were observed and measured under operating microscope through posterior tympanum approach entering posterior tympanum.@*RESULT@#The average distances from suprameatal spine to short crus of incus, pyramid segment of facial canal were 19.14 mm, 16.30 mm, respectively. The average distances from pyramid segment of facial canal to the surface of mastoid, crotch of chorda tympani nerve, posterior wall of auditory meatus were 20.84 mm, 11.28 mm, 4.40 mm, respectively. The average length of facial nerve in the horizontal segment, the perpendicular paragraph was about 11.60 mm, 15.30 mm, respectively. The average distance from pyramidal eminence to the anterior lip of round window niche, from oval window to round window niche, from incudostapedial joint to round window niche was 4.46 mm, 3.74 mm, 3.80 mm, respectively. The included angle of facial nerve in the horizontal segment and chorda tympani nerve with facial nerve in the perpendicular paragraph was 110.4 degrees, 24.8 degrees, respectively. Horizontal semicircular canal and facial nerve in the level paragraph was 17.5 degrees, long process of incus and incus buttress was 46.0 degrees.@*CONCLUSION@#The position of anatomic structure in middle ear was constant and the relationship including distance and angle between anatomic structures changed in limited region. The anatomical parameters provide a reference value for avoiding the injury during the operation.