Clinical analysis of AIDS-related Kaposi's sarcoma in head and neck / 中国耳鼻咽喉头颈外科

OBJECTIVE To summarize the clinical features of the acquired immunodeficiency syndrome-related Kaposi's sarcoma(AIDS-KS) in head and neck. METHODS The clinical data of 20 inpatients with AIDS-KS in head and neck from June 2009 to September 2016 in Beijing Ditan Hospital were retrospectively analyzed. RESULTS All 20 patients were male, median age 38.50±10.98. One case was Manchu, 1 case was of Uygur, and others were Han nationality. There were 7 cases with homosexuality history, 2 cases with blood transfusion history, and 1 case with prostitution history. Mass in head and face was the first symptom in 10 cases. The head and neck skin and mucosa were involved, including 2 cases with nasal mucosa involvement, 4 cases with auricle skin involvement, 8 cases with oral mucosal involvement, 3 cases with facial skin involvement, 1 case with neck skin involvement, 1 case with eyelid conjunctiva involvement. Four cases had disseminated lesions. When diagnosed, the CD4+T lymphocyte were 52.55±47.87/mm3. The CD4+T were less than 200/mm3 in all of the patients, including CD4+T＜50/mm3 in 15 cases(75％). After treatment with highly active antiretroviral therapy combined with or without chemotherapy, 12 cases were discharged. Eight cases died due to respiratory failure or septic shock or other reasons. CONCLUSION Kaposi's sarcoma of the head and neck might be the first visit of AIDS patients. Some of the patients get partial remission after highly active antiretroviral therapy and the overall prognosis is poor.

Acupuncture at the sphenopalatine ganglion for the treatment of patients with moderate-to-severe allergic rhinitis / 国际中医中药杂志

Objective To assess the clinical efficacy of acupuncture at the sphenopalatine ganglion for the treatment of patients with moderate to severe allergic rhinitis.Methods 42 cases of moderate to severe allergic rhinitis patients in Otorhinolaryngology clinic of Tongren Hospital between August 2012 to November 2013 were randomized into a treatment group and a control group. The treatment group was treated by acupuncturing sphenopalatine ganglion, once per week, altogether 4 times. The control group was treated by acupuncturingFengchi(GB20),Baihui(GV20),Yingxiang(GV29),Shangxing(GV23),Taiyang(EX-HN5), Quchi(LI11) andZusanli (ST36) was used in the control group, 3 times per week for 4 weeks. The changes of the Total Nasal Symptoms Score (TNSS) and the Total Non-Nasal Symptom Score (TNNSS) were evaluated before and after treatment. The Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was used to evaluate the quality of life.Results One week after treatment, the scores of TNSS, TNNSS and RQLQ in both groups were significantly improved than before the treatment (treatment group: 5.0[4.0, 6.0]vs. 9.0[7.0, 10.0], 1.0[1.0, 1.5]vs. 3.0[3.0, 3.0], 44.0[35.5, 50.0]vs. 60.0[53.5,75.0]; control group: 6.0[5.5, 8.0]vs. 10.0[8.5, 10.1], 2.0[2.0, 3.0]vs. 3.00[3.0, 3.0], 50.0[45.5, 58.0]vs.43.0[27.0, 48.0]; allP<0.01); the scores of TNSS, TNNSS and RQLQ 1 week after treatment in the treatment group were significantly improved than those in the control group. The scores of TNSS(2.0[1.0, 3.0]vs. 3.0[2.0, 4.5]), TNNSS(1.0[0.0, 1.0]vs.2.0[2.0, 3.0]) and RQLQ(24.0[19.0, 29.0]vs. 43.0[27.0, 48.5])4 week after treatment in the treatment group were significantly improved than those in the control group(allP<0.01).Conclusions Acupuncture at the sphenopalatine ganglion could relieve the symptoms and improve the quality of life in patients with moderate to severe allergic rhinitis, and show more rapid and persistent therapeutic effect. It may be superior to the common acupuncture.

Prediction of the original location of sinonasal inverted papilloma by preoperative imaging / 临床耳鼻咽喉头颈外科杂志

Sinonasal inverted papilloma (SNIP) is one of the most common benign sinonasal tumors demonstrating a high recurrence rate after surgery, and sometimes presents malignant tendency or coexists squamous cell carcinoma. Therefore, it is essential to achieve complete surgical resection, especially the original location of SNIP. In this paper, we evaluated the predictability of preoperative CT and magnetic resonance imaging (MRI) for localization of SNIP origin.

Pharyngeal ulcer in patients with acquired immune deficiency syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To understand the high incidence of pharyngeal ulcer in patients with acquired immune deficiency syndrome (AIDS). By analyzing the clinical features in AIDS patients with pharyngeal ulcer, this study provided reference for clinicians.</p><p><b>METHODS</b>Twenty AIDS patients with pharyngeal ulcer were retrospectively analysed to explore its clinical features and mechanism, and to explore the feasible therapeutic methods.</p><p><b>RESULTS</b>The patients generally had severe sore throat and dysphagia for 7 days to 8 months, resulting in significant weight loss. Common therapeutical method does not work. The ulcers developed mainly at vestibule of pharynx (10 cases), tonsil (3 cases), epiglottis (3 cases) and pyriform sinus (2 cases). Ulcer types included major aphthous ulcer (MaAU, 14 cases), fungal ulcer (2 cases), herpes zoster (1 case), ulcer secondary to drug eruption(1 case ), and lymphoma(2 cases). The disease course was long with CD4(+) T lymphocytes decreased significantly. Treatment was given with highly active antiretroviral therapy (HARRT), regulation of immune function, analgesic, anti-inflammatory and anti fungal. Treatment lasted from 2 weeks to 3 months, ulcer healed in 13 cases; 1 patient lost to follow-up, 6 patients dead.</p><p><b>CONCLUSIONS</b>The manifestation of pharyngeal ulcer in AIDS patients has its particularity. It is often associated with a variety of opportunistic infection and tumors. Local treatment is preferred. HAART therapy and systemic comprehensive treatment play more important and effective role. Pharyngeal ulcer persists for a long time, complicated with fever, diarrhea and other symptoms. The history of blood transfusion, injection drug use or unsafe sexual behavior may predict HIV infection.</p>

Clinical study of chronic invasive sinusitis caused by dematiaceous fungi / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the clinical presentation, diagnostic criterion and treatment principle of chronic invasive sinusitis caused by dematiaceous fungi.@*METHOD@#One patient was diagnosed as chronic invasive sinusitis based on history, headache, especially eye symptoms without fever, sinus CT and MRI, endoscopic and cytological findings in the nasal cavity. Surgical debridement was performed, and the patient was administered with systemic anti-fungi treatment.@*RESULT@#Alternaria was identified on culture. The patient was proved of tissue invasion histopathologically through biopsy. The patient survived after treatment without recurrence.@*CONCLUSION@#Extensive and aggressive surgical debridement, prompt and adequate dosage of intravenous antifungal therapy , together with controlling of the underlying disease, all contribute to a complete resolution of the disease.

Value of Three-dimensional Interactive Localization of the Anterior Ethmoidal Canals in Minimally Invasive Nasal Surgery / 中国微创外科杂志

Objective To explore the value of three-dimensional interactive localization of the anterior ethmoidal canals(AECs)in minimally invasive nasal surgery.Methods Thin-section three-dimensional CT images of the paranasal sinus in 80 patients(160 sides)were analyzed by using interactive localization system.The length and angulation of the AECs were recorded.The relationship between the positions of the AECs and anatomical landmarks were viewed in coronal and sagittal planes.Results The length and angulation of the AECs were(6.9?1.8)mm and(126.6?16.0)?,respectively.The distance between the anterior ethmoidal foramen and the anterior ethmoidal canal to the roof was(7.0?2.2)mm and(2.8 ? 2.0)mm,respectively.The AEC was identified as a suspending separate canal in 35.0%(56/160)sides.In the AECs plane on coronal images,the sagittal part of middle turbinate was found as 74.4%(119/160),the basal lamella of middle turbinate was 25.0%(40/160),and the superior turbinate was 0.6%(1/160).While on the sagittal planes,the position of AECs located on the basal lamella of ethmoida,on the basal lamella of middle turbinate,between the basal lamella of uncinate process and the basal lamella of ethmoida,between the basal lamella of ethmoida,and the basal lamella of middle turbinate were found in 23.8%(38/160),45.0%(72/160),1.2%(2/160)and 30.0%(48/160)of the cases,respectively.Conclusion AECs can be measured and located correctly by three-dimensional interactive system.