[Endoscope-assisted transoral resection of parapharyngeal space tumors: a retrospective study].

Objective:To evaluate the feasibility and safety of the endoscope-assisted transoral approach for the parapharyngeal space（PPS） tumors. Method:This retrospective study included 22 patients who were diagnosed with PPS tumors and treated with the endoscope-assisted transoral approach. Result:The postoperative pathological diagnosis included 10 cases of schwannoma, 7 cases of pleomorphic adenoma, 1 case of paraganglioma, 1 case of branchial cleft cyst, and 3 cases of malignant tumors for a diagnostic purpose. The surgical duration was between 15 minutes and 430 minutes（median duration 105 minutes）, and the intraoperative bleeding was between 10ml to 500ml（median bleeding 20 mL）. Complete resection with minor complication was performed in 21 cases, 1 case of recurrent schwannoma was done in an incomplete style because of intraoperative massive bleeding. With a 12-to-72-months follow up, there was no relapse on the 18 cases of benign tumor which were completely resected. Conclusion:Endoscope-assisted transoral resection provide cosmetic, micro-invasive and increased operative exposure to the PPS, especially for the benign tumors that medial to the carotid sheath. But is not recommend for relapsed cases and lesions that encompassing or lying posterolateral to the carotid sheath.

The influence of house dust mite sublingual immunotherapy on the TSLP-OX40L signaling pathway in patients with allergic rhinitis.

BACKGROUND: This study aimed to investigate the clinical efficacy of sublingual immunotherapy (SLIT) with house dust mite (HDM) extract and to examine T helper 2 (Th2)-type immune responses mediated by the thymic stromal lymphopoietin (TSLP-OX40L) signaling pathway in patients with moderate to severe allergic rhinitis (AR) after 12-month HDM SLIT. METHODS: Forty-six cases of HDM-sensitized patients with persistent AR in southern China were enrolled in this study. Clinical efficacy of SLIT was assessed by determining the individual nasal symptom score (INSS) and total nasal symptom score (TNSS) after 12-month HDM SLIT. Moreover, the TSLP-OX40L signaling pathway was investigated through measurements of TSLP by enzyme-labeled immunosorbent assay (ELISA) and OX40L by quantitative reverse transcription polymerase chain reaction (qRT-PCR) and flow cytometry. RESULTS: After 12 months of HDM SLIT, TNSS and INSS were significantly decreased overall compared with baseline values (p < 0.001). By the end of the 12-month HDM SLIT, TNSS had declined by ∼50% compared with baseline, and the corresponding level of TSLP in nasal lavage decreased significantly (p < 0.05). The level of OX40L messenger RNA (mRNA) in blood was markedly decreased significantly after 12-month HDM SLIT compared with baseline (t = 12.300, p < 0.05). Furthermore, significant decreases in OX40L expression on the surface of peripheral blood mononuclear cells (PBMCs) (t = 13.100, p < 0.05) and OX40L expression on the surface of CD11c+CD86+ cells in PBMCs (t = 9.946, p < 0.05) after 12-month HDM SLIT were observed. CONCLUSION: HDM SLIT downregulated Th2-type immune responses mediated by the TSLP-OX40L signaling pathway in patients with persistent moderate to severe AR.

[Evaluation of tympanoplasty with reconstruction of the external canal after mastoidectomy for cholesteatoma].

OBJECTIVE: To investigate the method to repair the deletion of external canal and opened mastoid space after mastoidectomy. METHOD: One stage tympanoplasty with reconstruction of the external canal with temporal cortex was completed in 58 cases (58 ears) with cholesteatoma. RESULT: During the follow-up ranging from one to three years, there was only one relapse. The configuration of external canal was almost normal and pneumatic mastoid space was maintained. Hearing was improved over 30dB in five ears, 20 to 29 dB in 11 ears, 10 to 19 dB in 30 ears, less 10 dB in eight ears and hearing wasn't improved in four ears. CONCLUSION: One stage tympanoplasty with reconstruction of the external canal after mastoidectomy for cholesteatoma is a practical way to improve hearing and decrease recurrence.