Clinical analysis of 40 cases with sinonasal adenoid cystic carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the clinical characters and the mode of treatment, and to analyze the prognosis of patients with sinonasal adenoid cystic carcinoma.</p><p><b>METHODS</b>The clinical data were analyzed retrospectively in 40 patients with sinonasal adenoid cystic carcinoma. The characters of survival rate, local recurrence and distant metastasis in these patients were analyzed using Kaplan-Meier method and Log-rank test.</p><p><b>RESULTS</b>The maxillary sinus was the most common site of origin and account for 80% of all patients. Five-year and ten-year overall survival rate were 76.9% and 61.6% respectively. Five-year and ten-year disease-free survival rate were 44.2% and 23.0%. Five-year local recurrence rate and distant metastasis rate were 45.0% and 23.0%, respectively. The most common site of distant metastasis was lung. Presence of distant metastasis correlated with decreased 5-year survival (chi2=7.26, P=0.007). The distant metastasis rate of preoperative treatment (18.2%) seemed lower than that of postoperative treatment (38.9%), but there was no significant difference in the two groups (chi2=1.37, P=0.24). The combined therapy mainly composed of surgery was adopted to treat the local recurrence. Five-year survival rate after development of local recurrence was 60.0%.</p><p><b>CONCLUSIONS</b>Distant metastasis is an important factor affecting the prognosis of the patients with sinonasal adenoid cystic carcinoma. Combined therapy composed of surgery and radiation was the first choice of treatment to the patients with sinonasal adenoid cystic carcinoma. Radiation can play an important role in the treatment. The combined therapy mainly composed of surgery should be adopted in the patients with local recurrence to improve the survival rate.</p>

Esophageal voice training and quality of life in laryngectomees / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the extensive and degree of physical rehabilitation improvement of the quality of life in laryngectomees.</p><p><b>METHODS</b>Forty nine patients who underwent total laryngectomies were trained by esophageal voice rehabilitation successfully. The questionnaires of performance status scale for head and neck cancer patients (PSS-HN) and the functional assessment of head and neck cancer therapy (FACT-H&N) were answered by them before esophageal voice training and 3 months after successful vocal rehabilitation.</p><p><b>RESULTS</b>Total laryngectomy deteriorated the quality of life in laryngectomees. The mean scores of PSS-HN scale and FACT-H&N questionnaire were lower than the criteria scores after patients underwent total laryngectomy, the mean score were 131. 4,90.6 respectively, the difference was significant statistically (t =53. 673, P <0.001) , (t = 67.44, P <0.001). After successful esophageal speech training, the mean scores of the laryngectomees were improved both in PSS-HN scale and FACT-H&N which were 240.4 and 103.7 respectively, the difference was significant statistically (t = 18.209, P < 0.001) , (t = 21.389, P<0.001).</p><p><b>CONCLUSIONS</b>The quality of life in laryngectomees can be improved by physical rehabilitation and the esophageal voice training.</p>