Recurrent facial palsy in Melkersson Rosenthal syndrome: total facial nerve decompression is effective to prevent further recurrence.

OBJECTIVE: To study the role of total facial nerve decompression in preventing further recurrence of facial palsy in Melkersson Rosenthal syndrome (MRS). METHODS: Total facial nerve decompression was performed on nine patients with recurrent facial palsy in MRS, and prednisolone treatment was given to 6 cases who declined surgery. They were incorporated into surgery group and control group, respectively. Patients in surgery group and control group were followed up for 5.4 ± 1.4 years (range, 4 to 8 years) and 6.0 ± 1.4 years (range, 4 to 8 years), respectively. RESULTS: Further episodes of facial palsy affected none of 9 cases (0.0%) in surgery group, while they affected 3 of 6 cases (50.0%) in control group, with significant difference (p<0.05). CONCLUSIONS: Total facial nerve decompression was effective to prevent further episodes of facial palsy in MRS.

[The correlation research between the polymorphism of genotype of site-1296 in alpha2A-AR receptor gene and the susceptibility of vestibular function].

OBJECTIVE: To investigate the correlation between the polymorphism of genotype of site-1296 in alpha2A-AR receptor gene and the susceptibility of vestibular function. METHOD: Ninety-four blood samples were collected from pilot cadets, consisting of susceptible and tolerance groups to vestibular function. Genomic DNA was isolated, and the coding region of alpha2A-AR receptor gene was amplified by polymerase chain reaction (PCR). The PCR products were analyzed by gene sequencing. Gene frequency was calculated, and, the coincidence between the polymorphism of alpha2A-AR receptor gene in the groups and Hardy-Weinberg balance was evaluated. The allele frequency of the two groups was compared by Chi square test. RESULT: G/C polymorphism was existed in Site-1296 of alpha2A-AR gene regulation zone, including GG, GC, CC. The express of GG Genotype in susceptible group exceeded that of the other group. There were significance differences in both genotype constituent ratio and alleles frequency of the two groups. CONCLUSION: The polymorphism of genotype of site-1296 in alpha2A-AR receptor gene is possibly correlated with the susceptibility to vestibular function.

[Clinical observation for the management of chronic hypertrophic rhinitis by endoscopic ethmoid and maxillary surgery].

OBJECTIVE: To evaluate the therapeutic effect of endoscopic ethmoid and maxillary surgery on chronic hypertrophic rhinitis. METHOD: A total of 54 cases of chronic hypertrophic rhinitis were treated by endoscopic ethmoid and maxillary surgery between 2003 and 2004, undergoing postoperative follow-up of more than one year. Age of patients ranged from 17 to 60 years, with a mean of 35 years. All of them were identified with nasal endoscopy and CT before surgery. RESULT: Fifty (92.59%) of 54 cases showed their nasal obstruction symptoms were relieved completely or improved significantly, with nearly normal infraturbinal appearance. CONCLUSION: Endoscopic ethmoid and maxillary surgery is an effective approach for the treatment of chronic hypertrophic rhinitis, with good preservations of infraturbinal structure and function.

[Misdiagnosis and mistherapy of ectopic thyroid gland].

OBJECTIVE: To explore the clinic characteristic, diagnosis and treatment of ectopic thyroid gland (ETG) and avoid the misdiagnosis and mistherapy of ETG. METHOD: The clinic materials of 4 cases with ETG were analysed. Four patients were misdiagnosed thyroglossal duct cyst. The clinical features, diagnosis and management of ETG were discussed. RESULT: All of patients had a normal thyroid gland in the neck and underwent a surgical resection of neck mass. Postoperative pathologic examination revealed the neck masses originated from accessory thyroid gland, of them, 1 gland enlargement, 1 adenoma and 2 adenocarcinoma. Fortunately, by the postoperative fellow up, no significant complication was found in the patients. CONCLUSION: The well understanding of ETG and the detailed examination before surgical treatment of neck mass, including ultrasonography, CT or MRI, radioactive isotope scanning and fine needle aspiration biopsy, are keys to adequate diagnosis and management of ETG.

A retropharyngeal lipoma causing obstructive sleep apnea in a child.

BACKGROUND: Lipomas are common benign tumors, but they rarely occur in the retropharyngeal space and even more rarely occur in children. CASE REPORT: We report the case of an 11-year-old girl with a 5-year history of progressively worsening nasal obstruction, snoring, and excessive daytime sleepiness. Physical examination revealed a child with a body mass index of 16.9 kg/m2; otolaryngologic examination and imaging studies showed a large retropharyngeal mass. Polysomnography indicated an apnea-hypopnea index of 13.9 events per hour of sleep and a minimum oxygen saturation of 84%, with 20 episodes of desaturation to less than 90%. After complete excision of the mass, the patient's snoring, apnea, and daytime sleepiness resolved. CONCLUSIONS: Although lipomas in the retropharyngeal space are rare, clinicians should be alert to the possibility of this condition occurring in children who have symptoms of obstructed breathing during sleep but a normal body mass index and no other risk factors for obstructive sleep apnea.