ABSTRACT
Fifty-five mucopyoceles in 53 patients were diagnosed during the 10-year period from 1982 to 1992 in our department. These included 8 from the frontal sinus, 25 from the maxillary sinus, 10 from the ethmoidal sinus, 1 from the maxillary and ethmoidal sinuses, 7 from the frontoethmoidal sinuses and 4 from the sphenoethmoidal sinuses. The patients ranged in age from 8 to 78 years (mean 47.1 years). The ratio of males to females was 31 to 22. The rhinologic symptoms occurred most often in maxillary mucopyoceles and were rare in the other groups whereas ophthalmic symptoms were noticed in most of the cases. All of the cases received surgery and postoperatively most of the initial symptoms subsided except that two patients still had occasional diplopia and one did not recover at all from complete blindness. Two cases had a recurrence and one suffered from subarachnoid hemorrhage shortly after discharge. Surgery is the only treatment modality for mucopyoceles and the building of a new patent communication between the lesion and nasal cavity is important for the success of this surgery.
Subject(s)
Mucocele/surgery , Paranasal Sinus Diseases/surgery , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Mucocele/diagnosis , Mucocele/microbiology , Paranasal Sinus Diseases/diagnosis , Paranasal Sinus Diseases/microbiologyABSTRACT
Hypopituitarism occurring in patients who received external cranial radiation therapy (RT) have been increasingly recognized. Fourteen healthy patients were collected as control Group I, and 25 patients with nasopharyngeal carcinoma (NPC) were enrolled as Group II. Another 18 NPC patients were enrolled as Group III. Blood was sampled from Group I, Group IIB (before RT), Group IIA (one week after RT) and Group IIIA (1 to 1.5 years after RT). The basal samples were taken for growth hormone (GH), adrenocorticotropic hormone (ACTH), cortisol, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), thyrotropin (TSH), triiodothyronine (T3) and thyroxine (T4). The results showed the T3 level was statistically low in Group IIB compared with Group I. The serum GH and FSH (male only) levels were higher and with statistical significance in Group IIA compared Group IIB. Both GH and ACTH levels decreased and PRL increased with statistical significance in Group IIIA compared with Group IIA. The ACTH decreased with statistical significance in Group IIIA compared with Group IIB. Clinical damage to the pituitary is usually manifested months to years after RT. Therefore, a careful exclusion of these glands from radiation treatment fields is recommended whenever possible.
Subject(s)
Nasopharyngeal Neoplasms/radiotherapy , Pituitary Hormones, Anterior/blood , Adult , Aged , Female , Humans , Hypopituitarism/etiology , Male , Middle Aged , Radiotherapy/adverse effectsABSTRACT
Eighty nasopharyngeal carcinoma (NPC) patients and another eighty head and neck cancer (HNC, non-NPC) patients were enrolled as two experimental groups to study their salivary function by using Tc99m sialography. Twenty healthy subjects were also employed as a control group. The patients received an intravenous injection of 4 mCi of 99mTc-pertechnetate (Tc-99mO4-). The data were collected at a rate of 1 frame per 15 seconds for the total time of 30 minutes, and the patients received stimulations for salivary secretion by ingesting 0.5cc of lemon juice 15 min after the start of data acquisition. The salivary function was measured on Pre-RT (radiation therapy), During-RT and Post-RT periods. The results showed no statistical significance for maximum uptake (%) and excretion rate (%) between Control and Pre-RT group on parotid or submandibular glands function. This was the same in the age groups (age below 40 and age above 40) and sex groups. The NPC group had a decreasing maximum uptake (%) 3 months after RT on both parotid glands and submandibular glands, whereas the HNC group showed no obvious difference. The excretion rate (%) of both parotid and submandibular glands reached its lowest mark after 3-6 months in both the NPC and HNC groups and then started to recover progressively. For NPC patients, the radiation damage to the parotid glands was greater than to the submandibular glands, whereas the effect was reversed on HNC patients. It is important that the radiation therapist should preserve salivary function whenever possible.
Subject(s)
Head and Neck Neoplasms/radiotherapy , Salivary Glands/radiation effects , Adolescent , Adult , Aged , Female , Head and Neck Neoplasms/physiopathology , Humans , Male , Middle Aged , Radiotherapy/adverse effects , Salivary Glands/physiopathologyABSTRACT
In the past, radiation therapy was the main treatment modality in nasopharyngeal cancer, but recently, combined induction chemotherapy has become a trend. In this study patients with NPC were divided into two groups. In Group I, 46 cases were treated with chemotherapy (Cisplatin + 5-Fu) and radiation. In Group II, 49 cases were given radiation only. The side effects of chemotherapy were tolerable except for 2 dropouts due to intractable vomiting and semi-coma respectively. Only 17 cases got leukopenia and one case was graded I in BUN evaluation. All of the cases were within normal limits in the platelet and creatinine evaluation. Nine cases acquired hyponatremia. The response rate was 72.7% in the primary site which included 22.7% of the complete response and 50.0% of the partial response with a 80.0% response rate in neck site, which included 56.7% of complete response and 23.3% of partial response. But after the consecutive radiation, the differences of response rate did not show any significance between the two groups. The difference in the response rate between non-keratinizing and undifferentiated carcinoma were significant.
