Individual nasal endoscopic surgery for non-sinusitis-related rhinogenous headache: our experience in 68 cases / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the role of anatomical abnormalities in non-sinusitis-related rhinogenous headache and to evaluate effects of nasal endoscopic surgery for non-sinusitis-related rhinogenous headache.@*METHOD@#Sixty-eight patients diagnosed as non-sinusitis-related rhinogenous headache were selected in this study. They were treated with nasal endoscopic surgery after failed long-term medical treatment. Data from this group were analyzed retrospectively.@*RESULT@#Multiple anatomical abnormalities were noted by endoscopy and sinus computed tomographic scans in the 66 patients. These included nasal septum deviation in 46 cases (67.6%), middle turbinate gasfication in 20 cases (29.4%), protruding ethmoid bulla or uncinate processor in 10 cases (14.7%) and abnormal middle turbinate in 8 case (11.8%). Fifty-six (82.4%) patients showed significant improvement after surgery.@*CONCLUSION@#Non-sinusitis-related rhinogenous headache can be significantly minimized with individual nasal endoscopic surgery, as long as a precise identification of the etiologic anatomical factor can be made.

Laryngeal function preserving surgery in elderly hypopharygeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the indications and the effective treatment methods of laryngeal function preserva tion in aged patients with hypopharyngeal carcinoma.@*METHOD@#Clinical data about 41 patients with hypopharygeal carcinoma were analysed. These patients were more than or equal to 60 and were treated from January 2006 to December 2011. Among them, 25 cases were treated with laryngeal functions preserved and the hypopharynx defect was immediately re paired by the adjacent tissue flap or (and) the pactoralis major myocutaneous flap according to the size of defect after tumor resecting. The survival rate was calculated by Kaplan-Meier method.@*RESULT@#In 25 patients with laryngeal function preservation, 16 cases were 60-69 years old, 6 cases were 70-79 years old and 3 cases were 80-88 years old. The tumour located at lateral wall of pyriform sinus in 14 cases, at anterior wall of pyriform sinus in 3 cases, at inside wall of pyriform sinus in 3 cases, at upper side wall of hypopharynx invading tonsil or tongue base in 3 cases, at posterior hypopharyngeal wall in 2 cases. The average length of post-operation stay was 22.2 days. Eight cases suffered from post-operative complications (32%), including of pharyngeal fistula in six cases and pulmonary infection in two cases. The respiratory function and pronunciation were all restored, in 25 cases, among which 20 cases removed tracheostomy tube about 3 months after surgery. 2 cases were missed after 1-year followed up. 2 cases died of local tumor recurrence. 4 cases died of neck recurrence. 8 cases died of pulmonary matastasis. The 1-year and 3-year survival rate of the disease in the group was 67.5% and 43.9% respectively.@*CONCLUSION@#As the aged cases of hypopharygeal carcinoma are choosed appropriately and repaired feasibly, surgery for the disease with laryngeal function retention may be safe and effective.