[Correlations of 18F-Fluorodeoxyglucose Positron Emission Tomography/Magnetic Resonance Imaging Parameters with the Pathological Differentiation of Head and Neck Squamous Cell Carcinoma and Their Diagnostic Efficiencies].

Objective To evaluate the correlation of the positron emission tomography/magnetic resonance imaging (PET/MR) parameters with the pathological differentiation of head and neck squamous cell carcinoma(HNSCC) and the diagnostic efficiencies of PET/MR parameters. Methods Patients with clinical suspicion of HNSCC were included and underwent PET/MR scan. HNSCC was pathologically confirmed in all these patients. The PET/MR examination included PET and MR sequences of diffusion-weighted imaging (DWI) and T2-and T1-weighted imaging. The multiple parameters of PET/MR included the mean values of apparent diffusion coefficient(ADCmean) and the maximum and mean values of standardized uptake value (SUVmax and SUVmean) were measured and estimated. The correlations of all the parameters and distribution between the different tumor differentiation groups were analyzed. Logistic regression was utilized to build the model as the PET/MR combined parameter for predicting the differentiation by multiple parameters of PET/MR. The receiver operating characteristic curve was calculated for each parameter and the combination. Results Totally 23 patients were included in this study:9 patients (9 males and 0 female) had well-differentiated tumor,with an average age of (61.0±6.8)years;14 cases had moderately-differentiated (n=10) or poorly-differentiated tumors (n=4),with an average age of (62.0±9.1) years. All the patients were males. There was statistical correlation between SUVmean and SUVmax (P<0.001);however,ADCmean showed no statistical correlation with SUVmax and with SUVmean (P=0.42,P=0.13). ADCmean and SUVmean showed significant difference between well-differentiated group and moderately-poorly-differentiated group (P=0.005,P=0.007). Compared with the individual parameters,the combination of PET/MR parameters with SUVmean and ADCmean had higher efficacy in predicting tumor differentiation,with an area under curve of 0.84. Conclusions The distributions of ADCmean,SUVmax and SUVmean differ among HNSCC with different pathological differentiation. Compared with the individual parameters,the combination of the PET/MR parameters has higher efficiency in predicting tumor differentiation.

[Three-dimensional Pseudo-continuous Arterial Spin Label Non-contrast Enhanced Perfusion Imaging of Head and Neck Tumors with High-field MR System].

OBJECTIVE: To evaluate the feasibility of three-dimensional pseudo-continuous arterial spin label (3D pCASL) non-contrast enhanced perfusion imaging applied to head and neck tumors in high-field MR and detect the effects of different postlabeling delay (PLD) time on image quality and the reliability of repeated measurements of tumor blood flow (BF) in different 3D pCASL groups. METHODS: In this prospective study,all the 25 patients received neck 3D pCASL non-contrast enhanced perfusion examinations in a 3.0 T MR system by using an 8-channel head and neck joint coil. Conventional T1-weighted (TIWI) and T2-weighted imaging (T2WI) were performed firstly. Finally,three 3D pCASL with different PLD time [ASL1(PLD1=1525 ms),ASL2 (PLD2=2025 ms), ASL3(PLD3=2525 ms)] were acquired. Patients' perfusion-weighted images acquired from different 3D pCASL sequences underwent the analysis of signal to noise ratio (SNR) and contrast noise ratio (CNR) for tumors. Two observers performed the qualitative assessments on spiral artifacts and vascular artifacts of perfusion-weighted images from different 3D pCASL sequences. Blood flow (BF) of tumors from different 3D pCASL sequences were measured by the two observers respectively for the first time and by observer 2 for the second time. RESULTS: Seventeen enrolled patients (age:50.1 ± 12.7 years,M/F=10:7) with histopathologic. RESULTS: underwent the evaluation of image quality and measurements of BF values. The SNRs and CNRs of ASL1,ASL2, and ASL3 showed a descending trendency. SNRs (P=0.011) and CNRs (P=0.009) of ASL1 were significant higher than those of ASL3. There was no significant difference of scores of spiral artifacts among the three ASL groups (P=0.932). The scores of vascular artifacts of ASL1,ASL2,and ASL3 showed a descending trendency,also. And scores of ASL1 was significant higher than that of ASL3(P=0.000). The intraclass correlation coefficient (ICC) of intre-and intraobserver were high (ICC>0.9). Although the BF values of ASL1,ASL2, and ASL3 showed an ascending trendency,there was no significant difference among the three groups (P=0.977). CONCLUSIONS: The 3D pCASL no-contrast enhanced perfusion MR imaging can be used for head and neck tumor. The image quality of perfusion weighted images and reliability of BF measurements were satisfied. The 3D pCASL series with PLD of 1525 ms and 2025 ms have better image quality than PLD of 2525 ms. And BF values do not show significant statistic difference among the three groups. Therefore, 3D pCASL series with PLD of 1525 ms and 2025 ms are more suitable for the perfusion imaging of head and neck tumors

A novel classification of tracheal defects and the reconstruction strategies: A retrospective study based on 106 cases.

Objective: The study aims to present a novel classification of tracheal defects and the corresponding reconstruction strategies. Methods: The retrospective study was designed to analyze patients with diagnosed primary or secondary tracheal tumors from 1991 to 2020. Surgical techniques, complications and prognosis were reviewed. Airway status and patient outcomes were the principal follow-up measures. Tracheal defects were classified into two plane sizes (vertical (V) and horizontal (H) planes). Vertical defects were further categorized into three groups based on their tracheal ring numbers (V1, ≤ 5 rings; V2, 6-10 rings; and V3, > 10 rings). Tracheal defects with horizontal plane size H1 and H2 represent defects less and more than one-half the circumference of trachea. Thus, suitable reconstruction strategies were planned primarily based on "V" and "H" classifications. The reconstruction strategies performed were sleeve resection followed by an end-to-end anastomosis, window resection with sternocleidomastoid myoperiosteal flap reconstruction, defects conversion with rotation anastomosis, and modified tracheostomy with secondary flap reconstruction. Results: A total of 106 patients diagnosed with tracheal defects were enrolled in the study, of whom 59 patients underwent sleeve resection followed by end-to-end anastomosis; 40 patients received window resection alongside sternocleidomastoid (SCM) myoperiosteal flap reconstruction; five patients received converting defects with rotation anastomosis and two patients underwent modified tracheostomy with secondary stage flap reconstruction. Lumen stenosis occurred in three V2H1 defect cases and were treated by a second reconstruction surgery. Iatrogenic unilateral recurrent laryngeal nerve paralysis occurred in two patients with the V3H2 defect type, who were treated by temporary tracheotomy and partial vocal cord resection and extubated successfully during follow-up. All 106 patients achieved airway patency with adequate laryngeal function at the end of follow-up. No anastomotic dehiscence or bleeding occurred in any patient postoperatively. Conclusion: Though a significant number of multicenter studies concerning the reconstruction and classification of tracheal defects are needed, the study herein provides a novel classification of tracheal defects, which is primarily developed on the defect size. Therefore, the study might serve as a potential source for identifying suitable reconstruction strategies for practitioners.

[Diagnosis and treatment of diverticulums in laryngopharynx and cervical esophagus].

OBJECTIVE: To explore the clinical presentations, diagnosis and treatment of diverticulums in laryngopharynx and cervical esophagus. METHODS: Nineteen cases of diverticulums in laryngopharynx and cervical esophagus with general clinical information available from 1985 to 2010 at Peking Union Medical College Hospital were reviewed retrospectively and analyzed with a literature review. RESULTS: One case of lateral hypopharyngeal pouch presented with fetor oris and pharyngalgia. Three cases of Killian-Jamieson diverticulums had fetor oris and dysphagia. Among 15 cases of Zenker diverticulums, 3 had fetor oris, sour regurgitation and dysphagia while another 12 cases were asymptomatic. Seven patients with subjective complaints underwent diverticulectomy through open surgeries or endoluminal approaches and their symptoms were resolved and no recurrences were found during a follow-up period of 6 months-18 years. In 12 cases of asymptomatic Zenker diverticulums, observation was adopted and there was no complaint during a follow-up period of 1 - 25 years. CONCLUSION: Lateral hypopharyngeal pouch, Killian-Jamieson diverticulum and Zenker's diverticulum are rare entities with different clinical presentations. For symptomatic diverticulum, the most common treatment is surgical resection of diverticulectom and the prognosis is satisfactory. But for asymptomatic diverticulum, observation suffices.

Using ketamine in a patient with a near-occlusion tracheal tumor undergoing tracheal resection and reconstruction: A case report.

BACKGROUND: Tracheal tumors may cause airway obstruction and pose a significant risk to ventilation and oxygenation. Due to its rarity, there is currently no established protocol or guideline for anesthetic management of resection of upper tracheal tumors, therefore individualized strategies are necessary. There are limited number of reports regarding the anesthesthetic management of upper tracheal resection and reconstruction (TRR) in the literature. We successfully used intravenous ketamine to manage a patient with a near-occlusion upper tracheal tumor undergoing TRR. CASE SUMMARY: A 25-year-old female reported progressive dyspnea and hemoptysis. Bronchoscopy showed an intratracheal tumor located one tracheal ring below the glottis, which occluded > 90% of the tracheal lumen. The patient was scheduled for TRR. Considering the risk of complete airway collapse after the induction of general anesthesia, we decided to secure the airway with a tracheostomy with spontaneous breathing. The surgeons needed to transect the trachea 1-2 cartilage rings below and above the tumor borders: a time-consuming process. Coughing and movement needed be minimized; thus, we added intravenous ketamine to local anesthetic infiltration. After tracheostomy, an endotracheal tube was placed into the distal trachea, and general anesthesia was induced. The surgeons resected four cartilage rings with the tumor attached and anastomosed the posterior tracheal wall. We performed a video-laryngoscopy to place a new endotracheal tube. Finally, the surgeons anastomosed the anterior tracheal walls. The patient was extubated uneventfully. CONCLUSION: Ketamine showed great advantages in the anesthesia of upper TRR by providing analgesia with minimal respiratory depression or airway collapse.

Ecological correlates of ectoparasite load in a rodent: Complex roles of seasonality.

Understanding the mechanisms driving parasite distributions is not only important for understanding ecosystem functioning, but also crucial for disease control. Previous studies have documented the important roles of host sex, host body size, host behavioral trait (such as boldness and trappability), and seasonality in shaping parasite load. However, few studies have simultaneously assessed the roles of these factors, as well as their interactions. In spring and summer of 2021, we conducted live trapping in Hohhot, China, to collect ectoparasites on Daurian ground squirrel (Spermophilus dauricus), a small rodent widely distributed in East Asian grassland. We then used generalized linear models to explore the effects of several biological factors (sex, body weight, trappability, and reproductive status) and seasonality on the abundance of ticks and fleas in S. dauricus. Significant but inconsistent seasonal effects were observed: tick load was significantly greater in summer than in spring, while flea load was greater in spring than in summer. Seasons also significantly interacted with host trappability and body weight to affect tick abundance. Our results highlight the importance of considering seasonal changes in parasitism, as well as interactions between season and host biological traits in shaping parasite distributions.

[Diagnosis and treatment of laryngeal neuroendocrine carcinoma].

OBJECTIVE: To summarize the clinical features of laryngeal neuroendocrine carcinoma (LNEC). METHODS: The clinical data of all LNEC patients hospitalized during the period of June 1988 - December 2010 were analyzed retrospectively. RESULTS: Among all LNEC 12 patients as confirmed by pathological examination, there were typical carcinoid (n = 1), atypical carcinoid (n = 4) (2 with cervical metastasis, 1 with paraneoplastic syndrome), small cell neuroendocrine carcinoma (n = 7) (1 with adenocarcinoma). All patients with typical and atypical carcinoid underwent surgery. And postoperative radiotherapy was offered for those diagnosed with advanced stage or cervical metastasis. They were followed up for 1 - 12 years without local recurrence. All patients with laryngeal small cell neuroendocrine carcinoma received chemotherapy and radiotherapy. And the follow-up period was 0.5 - 6 years. One died of pulmonary metastasis within half a year while another died of liver metastasis within 3 years. CONCLUSION: It is important to classify the LNEC patients correctly since their clinical course, treatment and prognosis varies greatly with the diagnosis. For typical and atypical carcinoid of larynx, partial or total laryngectomy and neck dissection may be performed depending on the site and extent of primary tumor. However, for laryngeal small cell neuroendocrine carcinoma, the mainstay of treatment is made up of chemotherapy and radiotherapy. And the prognosis of this type remains very poor.

[The effects of infrasound on the blood coagulation function of guinea pigs].

OBJECTIVE: To study the change of the blood coagulation function of guinea pigs exposed to 16 Hz/120 dB, 16 Hz/125 dB infrasound and to explore the mechanism of circulation system damage. METHODS: Seventy-two guinea pigs were divided into 3 groups: the control group, the group exposed to 16 Hz/120 dB infrasound for 1.5 h a day and the group exposed to 16 Hz/125 dB infrasound for 1.5 h a day. Each exposure group was divided into 4 sub-groups (8 guinea pigs a sub-group) which were exposed to infrasound for 1, 7, 14 and 21 d, respectively. The coagulation function and serum nitric oxide (NO) were measured for control group and all sub-groups after exposure to infrasound. RESULTS: The prothrombin time (PT), international normalized ratio (INR) and serum NO of group exposed to 16 Hz/125 dB infrasound were (31.16 ± 3.05) s, 2.53 ± 1.21 and (88.304 ± 52.601) µmol/L, respectively, which were significantly higher than those [(21.36 ± 0.10) s, 1.65 ± 0.07 and (30.943 ± 26.864) µmol/L] of control group (P < 0.05). PT and INR of sub-groups exposed to 16 Hz/125 dB infrasound for 14 and 21 d were significantly higher than those of control group. NO of sub-groups exposed to 16 Hz/125 dB infrasound for 1 week and 2 weeks were significantly higher than that of control group (P < 0.05), but NO of sub-group exposed to 16 Hz/125 dB infrasound for 3 weeks decreased slightly. CONCLUSION: The blood coagulation function of guinea pigs exposed to 16 Hz/125 dB infrasound decreased, PT and INR may be used as the indexes to assess of blood coagulation function change induced by the infrasound exposure.

[Effects of extracellular calcium concentration on platelets aggregation, coagulation indices and thromboelastography].

OBJECTIVE: To detect the effect of extracellular Ca2+ concentrations on test results of coagulation-related parameters. METHODS: Blood samples of outpatient medical volunteers were collected and then different doses of calcium chloride added. The rate of platelet aggregation (n = 42), prothrombin time (PT), thrombin time (TT) and activated partial thromboplastin time (APTT) (n = 21) and parameters of thromboelastography (n = 30) were detected according to the standard protocols by plasma turbidimetry, coagulation and recalcification respectively. RESULTS: When the plasma Ca2+ concentration was in the range of 0.1 - 33.7 mmol/L, the rate of platelet aggregation gradually increased with a increasing concentration of Ca2+. And the rates induced by adenosine diphosphate (ADP) and arachidonic acid (AA) were (51.8 +/- 9.6)% - (94.7 +/- 4.8)% and (64.4 +/- 12.2)% - (93.2 +/- 5.5)% respectively. When the Ca2+ concentration was 39.0 mmol/L, the rate decreased markedly [ADP (9.1 +/- 5.3)%, AA (11.1 +/- 4.5)%, both P < 0.01]. When the Ca2+ concentration was in the range of 0.1 - 33.7 mmol/L, the values of PT gradually increased with a increasing concentration of Ca2+. The values of TT changed in "V"-type and became minimum when the calcium concentration was 4.4 mmol/L. The values of APTT decreased with higher calcium concentrations and could not be determined when the concentration increased above 0.5 mmol/L. When the Ca2+ concentration was in the range of 0.4 - 27.3 mmol/L, the values of reaction time and coagulation time of thromboelastography changed in "V"-type and became nearly minimal at the Ca2+ concentration of about 2.1 mmol/L. The values of alpha angle and maximum amplitude changed in "V"-type and became maximal at the Ca2+ concentration of 2.1 mmol/L. CONCLUSIONS: The effect of Ca2+ concentration on the testing results of coagulation-related parameters is significant. A high calcium ( > or = 39 mmol/L) can inhibit the platelet aggregation, coagulation factor activity and blood coagulation. The Ca2+ concentration of 2.1 mmol/L seems to be the optimal concentration for thromboelastography by recalcification method.

Matched-pair analysis of survival in the patients with T3 laryngeal squamous cell carcinoma treated with supracricoid partial laryngectomy or total laryngectomy.

BACKGROUND: The survival outcomes between supracricoid partial laryngectomy (SCPL) and total laryngectomy (TL) were compared in the groups of matched-pair patients with T3 laryngeal squamous cell carcinoma (LSCC). METHODS: Patients with T3 LSCC were matched based on prognostic factors. The Kaplan-Meier curve and the Cox proportional hazards model were used for analysis on survival. RESULTS: A total of 212 patients with T3 LSCC were included after matching (106 underwent SCPL and 106 underwent TL). Multivariable analysis showed no differences in overall survival (hazard risk [HR]=1.15; 95% CI: 0.79-1.67; P=0.47), disease-specific survival (HR=1.11; 95% CI: 0.69-1.80; P=0.66), and recurrence-free survival (HR=1.07; 95% CI: 0.68-1.68; P=0.77) between the SCPL group and TL group. CONCLUSION: SCPL provides reliable therapeutic outcomes and can be used to avoid a TL surgery in some patients with advanced primary laryngeal cancer.

Papillary thyroglossal duct carcinoma: report of nine cases and review of literature.

BACKGROUND: Thyroglossal duct carcinoma (TDCa) is a rare malignancy. Thus, we summarized the clinical characteristics of TDCa to explore the strategy of diagnosis, surgical treatment, and prognosis of patients with papillary TDCa. CASE PRESENTATION: A retrospective study was conducted about the medical records of cases with TDCa. General information including the diagnosis, surgical treatment, and prognosis of patients were obtained and analyzed. A total of 480 patients with thyroglossal duct anomalies were treated in our hospital during 1981 to 2011. Nine patients were identified as papillary TDCa and Sistrunk procedure was performed in these patients. Total thyroidectomy and selected neck dissection were performed in 3 TDCa patients with additional multiple thyroid nodules at presentation, of whom one was diagnosed as papillary thyroid carcinoma and another was found to have lymph node metastases. With a median follow-up of 119 months, all patients were alive with no recurrences or metastases. CONCLUSIONS: Although the incidence of TDCa is very low, early diagnosis and surgical operation of TDCa should be performed as soon as possible. Besides, the pathological examination is the only way to confirm the diagnosis, and surgery, especially Sistrunk's procedure, is the prior choice of the treatments. In the presence of thyroid lesions or cervical lymphadenopathy, total thyroidectomy and neck dissection should be considered.

A malignant glomus tumor in the upper trachea.

Malignant glomus tumors are extremely rare, and a malignant glomus tumor in the trachea has not been described previously. In this report, we present the first known case of a malignant glomus tumor originating in the trachea.

[Clinical analysis of 14 patients with extraorbital inflammatory myofibroblastic tumor of the head and neck].

OBJECTIVE: To summarize the clinical features of extraorbital inflammatory myofibroblastic tumor (IMT) of the head and neck. METHODS: Fourteen cases of extraorbital IMT treated in recent 20 years were analyzed retrospectively. RESULTS: Of the 14 patients, 9 cases with limited lesion in maxilla (n = 5), mandible (n = 2) or neck (n = 2) underwent local resection, and no recurrences were found after 1.5 to 20.0 years; 3 cases diagnosed as maxillary IMT involved in orbit, hard palate or pterygopalatine fossa received conservative therapy (prednisone, prednisone plus radiotherapy or prednisone plus chemotherapy), and no disease progression was found after 6, 9 or 2 years respectively; and 1 case diagnosed as maxillary IMT involved in orbit and pterygopalatine fossa was confirmed with cervical metastases after two operations and died of brain invasion within 17 months. One patient with localized lesion around the common carotid artery was treated with prednisone and had no disease progression with a 2-year follow-up. CONCLUSIONS: Extraorbital IMT of the head and neck is a rare clinical entity. Pathology examination is required for final diagnosis. Corticosteroid administration may be a choice of treatments, and radical resection should be taken selectively for limited lesions.

[Diagnosis and treatment of facial nerve schwannoma in patients with normal facial nerve function or slight facial palsy].

OBJECTIVE: To investigate the diagnosis and treatment of facial nerve schwannomas with facial nerve function House-Brackmann grade (HB) ≤ grade II. METHODS: A retrospective study was conducted in Peking Union Medical College Hospital. We reviewed eight cases of facial nerve schwannomas with facial nerve function HB ≤ grade II, which were diagnosed and managed between Jan 1996 and March 2011. RESULTS: The initial presenting symptoms of the eight patients were not facial paralysis. Eight patients were misdiagnosed and six had mistreatment histry. CT and(or) MRI results in all patients showed that the tumors originated from different part of the facial nerves. All patients received operation. Facial nerves were completely preserved in four patients because of easy separation of the tumors from the facial nerves in surgery, facial function was gradeII-III over 17 - 180 months' follow-up. The tumors were attached with the facial nerves in two patients with wide extension involving cochlea and labyrinth, therefore the tumors were removed together with the attached facial nerves, and the nerves were repaired by using the greater auricular nerves. Facial function was grade VI over 56 - 79 months' follow-up. One patient refused to sacrifice the facial nerve, wide decompression of facial nerve and tumor was undertaken, facial function was grade III over 8 months' follow-up. One chorda tympani neuroma was removed with the branch of the facial nerve, facial function was grade II over 8 months' follow-up. CONCLUSIONS: The facial nerve schwannomas with facial nerve function HB ≤ grade II is difficult to diagnosis. The therapy strategy should depend on the patients' choice, position of the tumor and adherences of the tumor to facial nerve. Facial nerve could be preserved if the tumor is easy to be separated from the facial nerve during operation, if not, total remove the tumor and nerve repairment are indicted when invasion into the inner ear canal, cerebro pontine angle, cochlea or labyrinth. If patients refuse to sacrifice the facial nerve, facial nerve decompression and periodic follow-up are recommended.

Is the c.3G>C mutation in the succinate dehydrogenase subunit D (SDHD) gene due to a founder effect in Chinese head and neck paraganglioma patients?

OBJECTIVES/HYPOTHESIS: Three Chinese patients with head and neck paragangliomas have been reported to carry the c.3G>C mutation in the succinate dehydrogenase subunit D (SDHD) gene. In addition, in our hospital, two further patients were identified who have the same mutation. It is unclear whether the c.3G>C mutation in Chinese patients is a recurrent mutation or if it is due to a founder effect. We conducted haplotype analysis on these patients to answer this question. STUDY DESIGN: Individual case-control study. METHODS: Germ-line mutations were confirmed in the patients and their families examined in this study using direct sequencing. We also constructed and analyzed haplotypes in four Chinese families. Genotype frequencies were compared to the control group. RESULTS: Three of four families shared the same haplotype, which rarely occurred in the control group. The last family shared a very short area on the physical map with the other three families. CONCLUSIONS: There is a founder effect in Chinese head and neck paraganglioma patients carrying the SDHD c.3G>C mutation.

[MRI features of olfactory bulb volume in healthy middle and old-aged persons.].

OBJECTIVE: To investigate the differences of olfactory bulb (OB) volumes between younger and older, male and female, left-side and right-side in healthy middle and old-aged persons by MRI. METHODS: Ninety five healthy middle and old-aged volunteers (male:female = 45:50) were divided into 2 groups, group one included persons aged from 50 to 69, group two included persons elder than 70. The left-side, right-side and both-side volumes of OB, the volumes of brain and the ratio of OB/brain were measured by MRI. RESULTS: (1) The left-side and both-side volumes of OB (x(-) +/- s), the volumes of brain [(39.89 +/- 8.7) mm(3), (81.70 +/- 16.8) mm(3) and (1281.86 +/- 140.2) cm(3)] in 50 - 69 years old group were respectively larger than those in >/= 70 years old group [(34.45 +/- 10.4) mm(3), (72.10 +/- 19.3) mm(3) and (1165.77 +/- 165.3) cm(3)], and the differences reached statistical significance (t were respectively 2.649, 2.449, 3.516, all P < 0.05). There were no significant differences of right-side OB volumes and the ratio of OB/brain between 50 - 69 years old group and >/= 70 years old group (t were respectively 1.904, 0.616, each P > 0.05). (2) The male's OB volumes of left-side, right-side and both-side, the brain volumes and the ratio of OB/brain were respectively larger than females', and the differences reached statistical significance (t were respectively 4.461, 3.630, 4.399, 3.800, 2.400, all P < 0.05). (3) The right-side OB volumes were larger than left-side's and significant differences were found in female group, 50 - 60 years old group and >/= 70 years old group (t were respectively 2.732, 2.117, 3.516, all P < 0.05). There were no significant differences of OB volumes between left-side and right-side in female (t = 2.649, P = 0.110). The ratio of right-side OB/brain were larger than the ratio of left-side's and the differences reached statistical significance (t = 3.183, P = 0.002). CONCLUSIONS: MRI could be used to measure the volume of OB. The older the people, the smaller the OB volumes. There was no influence of age on the ratio OB/brain. The OB volumes of right-side were larger than those of left-side. The OB volumes of male were larger than those of female.

[Management of nasopharyngeal stenosis following uvulopalatopharyngoplasty].

OBJECTIVE: Severe nasopharyngeal stenosis (NPS) is a rare complication of uvulopalatopharyngoplasty (UPPP) and very difficult to manage. This report presents our successful treatment experience. METHODS: From Nov 1997 to Feb 2006, 6 adults patients with NPS secondary to UPPP were treated in Peking Union Hospital. Two cases was grade II stenosis, received surgery of local pharyngeal and soft palate mucosa flap rotation to enlarge nasopharyngeal airway with stenosis; For the remaining 4 cases with more severe NPS (grade III) who had received 1-3 times unsuccessful repair procedures previously, prolonged nasopharyngeal hollow obturators were used for 6 months after stenosis repair surgery. RESULTS: With 9-48 months follow-up, All cases results were satisfactory. Nasal obstruction symptom was eliminated, NPS corrected, no velopharyngeal insufficiency complication happened. Daytime removable nasopharyngeal hollow stent obturators with palate support device is more comfortable for patients. CONCLUSIONS: Local flap rotation to enlarge stenosis airway and prolonged use nasopharyngeal hollow obturators are reliable methods of correction NPS following UPPP.

[Diagnosis and therapy of glomus tympanicum and glomus jugulare tumors].

OBJECTIVE: To report on a series of patients with glomus tympanicum or glomus jugulare tumors, and to focus on its diagnosis, treatment, and outcomes. METHODS: Ten patients with glomus tympanicum or glomus jugulare tumors at Peking Union College Hospital during a 17-year period were reviewed retrospectively. RESULTS: There were 7 patients with glomus tympanicum, 3 with glomus jugulare tumors, 1 patient with familial paraganglioma and 1 with functioning glomus jugulare tumors. The most common presenting symptoms were pulsatile tinnitus and hearing loss. Other symptoms included facial nerve paralysis, vertigo, otalgia, dysphagia, hoarseness, throat sore, episodic hypertension with headaches and tachycardia. The most common physical sign was a vascular middle ear mass. The other physical signs included Brown sign, upper neck mass, pharyngeal plump, Collet-Sicard syndrome, Homer's syndrome as well as deficit of cranial nerve V. The radiographic evaluation included computed tomograph (9 cases), angiography (4 cases) and magnetic resonance imaging (1 case). Eight patients initially refered to ENT department, and 2 patients initially consulted neurology or endocrinology specialists. The treatment included preoperative embolization in 2 cases, simple surgery in 4 cases and surgery followed by radiation therapy in 6 cases. No significant complications occurred. Nine of the 10 patients were followed up, but 1 was lost. The mean follow-up time was 12 years (ranged, 2-19 years). No tumor recurrence occured in the 6 cases with total tumor removal. Three cases with subtotal tumor resection had no tumor progression. CONCLUSIONS: The diagnosis and treatment of glomus tympanicum and glomus jugulare tumors is particularly challenging. Typical clinical manifestations and radiographic evaluation should be considered together to establish the diagnosis. The primary treatment for glomus tympanicum is surgery, if necessary, followed by radiotherapy. Subtotal tumor resection followed by radiation yields satisfying outcome for glomus jugulare tumors.