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Objective:To investigate the effect of posterior nasal neurectomy（PNN） with pharyngeal neurectomy （PN） on chronic sinusitis with nasal polyps （CRSwNP）complicated with perennial allergic rhinitis （PAR）. Methods:83 patients with perennial allergic rhinitis combined with chronic group-wide sinusitis with nasal polyps who attended our hospital from July 2020 to July 2021 were selected. All patients underwent conventional functional endoscopic sinusitis surgery（FESS）+ nasal polypectomy. Patients were divided according to whether they underwent PNN+PN. 38 cases in the experimental group underwent FESS combined with PNN+PN; 44 cases in the control group underwent conventional FESS alone. All patients underwent the VAS, RQLQ, and MLK before treatment, and at 6 months and 1 year after surgery. Meanwhile, other relevant data were collected and the preoperative and postoperative follow-up data were collected and analyzed to assess the differences between the two groups. Results:The total postoperative follow-up period was 1 year. The recurrence rate of nasal polyps at 1 year postoperatively and the nasal congestion VAS score at 6 months postoperatively were not statistically significant in the two groups（P>0.05）. However, the patients in the experimental group had statistically significantly lower effusion and sneezing VAS scores, MLK endoscopy scores and RQLQ scores at 6 months and 1 year postoperatively, and nasal congestion VAS scores at 1 year postoperatively compared to the control group（P<0.05）. Conclusion:For patients with perennial AR complicated with CRSwNP, the combination of the PNN+PN in FESS can significantly improve the short-term curative effect, and PNN+PN is a safe and effective surgical treatment.
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Humans , Nasal Polyps/surgery , Rhinitis, Allergic/surgery , Sinusitis/surgery , Rhinitis, Allergic, Perennial , Endoscopy , Denervation , Chronic Disease , Rhinitis/complicationsABSTRACT
The aim of this study is to evaluate the efficacy of endoscopic surgery and conventional surgery combined with radiotherapy in the treatment of Neuroblastoma. Forty-three patients with olfactory neuroblastoma undergoing surgery combined with radiotherapy were retrospectively analyzed. The patients were divided into endoscopic surgery and conventional surgery. All patients received postoperative radiotherapy at a dose of 60-70 Gy, the 5-year survival rate and local recurrence time of the two groups were compared, and the therapeutic effects of endoscopic surgery and traditional surgery were compared. Through survival analysis, the 5-year overall survival rates of the traditional surgery group and the endoscopic surgery group were 50% and 58% （=0.560）, the local recurrence rates were 44% and 48% （=0.288）, and the mean recurrence time was 5.6 months and 12.5 months （=0.032）. There was no difference between endoscopic surgery and conventional surgery combined with radiotherapy in the treatment of Neuroblastoma, and the time of local recurrence was significantly prolonged. In early Neuroblastoma, endoscopic sinus surgery may be superior to open surgery in terms of efficacy and patient survival.
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Objective@#The aim of this study is to evaluate the efficacy of endoscopic surgery and conventional surgery combined with radiotherapy in the treatment of Neuroblastoma. @*Method@#Forty-three patients with olfactory neuroblastoma undergoing surgery combined with radiotherapy were retrospectively analyzed. The patients were divided into endoscopic surgery and conventional surgery. All patients received postoperative radiotherapy at a dose of 60-70 Gy, the 5-year survival rate and local recurrence time of the two groups were compared, and the therapeutic effects of endoscopic surgery and traditional surgery were compared.@*Result@#Through survival analysis, the 5-year overall survival rates of the traditional surgery group and the endoscopic surgery group were 50% and 58% （P=0.560）, the local recurrence rates were 44% and 48% （P=0.288）, and the mean recurrence time was 5.6 months and 12.5 months （P=0.032）.@*Conclusion@#There was no difference between endoscopic surgery and conventional surgery combined with radiotherapy in the treatment of Neuroblastoma, and the time of local recurrence was significantly prolonged. In early Neuroblastoma, endoscopic sinus surgery may be superior to open surgery in terms of efficacy and patient survival.
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Objective@#To investigate the cause and urgent management of internal carotid artery injury during transnasal endoscopic skull base surgery.@*Methods@#Five cases of internal carotid artery injury encountered during transnasal endoscopic skull base surgery in Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of University of Science of Technology of China, Anhui Provincial Hospital from December 2010 to July 2017 were analysed retrospectively. There were 2 cases of adenoid cystic carcinoma, 1 case of salivary gland-type adenocarcinoma, 1 case of petrous apex cholesterol granulomas and 1 case of squamous carcinoma. The cause of internal carotid artery injury and subsequent treatment were analysed, in order to prevent internal carotid artery injury during transnasal endoscopic surgery.@*Results@#Intraoperatively, all these 5 cases were packed with vaseline strip successfully. Two cases underwent subsequent intravascular covered stent graft implantation; 1 case underwent replacement of packing with muscle fascia graft; 1 case was packed with vaseline strip in nasal and nasopharyngeal cavity; 1 case accepted ligation of common carotid artery after failure of nasal packing. Four cases were successfully treated without craniocerebral or ocular complications. Otherwise, 1 case demonstrated with extremity paralysis after ligation. Follow up ranged from 6 to 84 months, no patient died.@*Conclusion@#The injury of internal carotid artery is related with improper operative procedures and anatomic localization, which should be treated properly with emergent hemostasis, and an experienced multidisciplinary team to repair vascular damage is very important.
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Objective To study the cutoff point of chronic nasal sinusitis with nasal polyps(CRSwNP) classified by the tissue eosinophils(Eos).Methods 140 CRSwNP patients were enrolled in this study.The data of their clinical feature were collectted before surgery.Mucosal specimens were assessed for the presence of tissue eosinophil cells.Follow up and record the data at 3 months and 6 months after surgery.Results When the tissue Eos grouped by 50/HPF, the VAS, nasal sinus CT ,endoscopic preoperative score,and the endoscopic postoperative score at 3 months and 6 months showed significant difference(P<0.05).The tissue Eos between skin prick test(SPT) positive group and SPT negative group showed no significant difference.The tissues Eos was sighificantly correlated with the peripheral Eos(ρ=0.459,0.473,P<0.01).Conclusion The most meaningful cutoff point may be 50 Eos/HPF nearby to distinguish ECRS and non-ECRS(taken nasal polyps,by random HPF).Allergic factors may have no effect or little effect on the increase in Eos of nasal polyps in patients with CRSwNP;peripheral blood Eos may be an indicator of the level of Eos in tissues.
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OBJECTIVE To evaluate theefficacy of the pedicled nasoseptal flap for anterior skull base reconstruction after endoscopic resection of sinonasal malignancies involving the skull base.METHODS From September 2008 to May 2016, 31 patients with sinonasal malignancies involving the skull base were treated via transnasal endoscopic surgery and then two type mucoperiosteal flap of contralateral nasal septum were used to repair the anterior skull base defect according to the actual situation, one is a flap supplied by the posterior nasal septal artery and the other is supplied by the anterior and posterior ethmoidal arteries.RESULTS Successful anterior skull base reconstruction was obtained in all 31 cases. Complications included 3 cases of intracranial infection without hemorrhage or hematoma. In addition, cerebrospinal fluid leakage occurred in one case because of tumor recurrence, and leakage was healed by vertebral draining for one week. Another one had occurred as a result of removing the support form nasal cavity.The follow-up lasted from 3 to 66 months, there were no necrosis of the flap or meningoencephalocele occurred and mucoperiosteal flap healed up well.CONCLUSION The vascularized nasoseptal flap is a reliable and preferred repairing material for anterior skull base reconstruction.
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Objective To observe the thickness and histologic changes of cartilage -perichondrium complex (CP) and vascular density changes in perichondrium after repairing perforated eardrum .Methods Forty -five male guinea pigs were randomly divided into three groups ,and were used to create left TM perforation .The left cavum conchae cartilage-perichondrium was immediately used to repair the perforation .The observation time for group A was two weeks ,group B was six weeks and group C was twelve weeks .The thickness of the composite was meas-ured before and after the implantation .The histologic changes of implants and the vascular change in perichondri were observed .Results The healing time for the left ear was 3 .8 ± 0 .84 ,and the right ear 7 .2 ± 0 .84 .The thick-ness of the composite for group A increased by 14 .4% (P0 .05) .Group C decrease by 14 .2% (P<0 .05) .After implantation ,the thickness of cartilage in group C was decreased by 34 .2% compared to that in group A (P<0 .05) .At the 2nd week in post -implantation ,the number of vessels within the unit area of fiber -perichondrium was up to 13 .28 ± 2 .49 ,while the above number reached to 7 .71 ± 2 .49 at the 6th week after implantation .The final histological structure of recon-structed tympanic membrane at the 2nd week and 6th week was composed of squamous epithelial layer ,fibrous -perichondrium layer ,cartilaginous layer and mucous layer .The above histological structure at 12th week was com-posed of squamous epithelial layer ,cartilaginous layer and mucous layer .Conclusion The healing time of the recon-structed tympanic membrane is shorter than the time spent on healing on its own .The thickness of the composite in post-implantation in three groups first increased and then decreased compared to that in pre -implantation .The number of blood vessels of fiber -perichondrium in the reconstructed tympanic membrane first increased and then re-duced .The layers of final histological structure of reconstructed tympanic membrane are similar to those of normal tympanic membrane .From the perspective of histology ,the cartilage-perichondrium composite is the suitable ma-terial for repairing tympanic membrane .
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<p><b>OBJECTIVE</b>To understand the expression of complement regulatory proteins CD55 and CD59, which secreted by epithelial cells of normal and chronic sinusitis patients.</p><p><b>METHODS</b>Cell culture and flow cytometry were used to detect the expression of complement regulatory proteins CD55 and CD59.SPSS 18.0 software was used to analyze the data.</p><p><b>RESULTS</b>CD55 was expressed both in normal nasal mucosa and mucosa of chronic sinusitis. The expression in normal group was 0.001 ± 0.001, significantly lower than that in CRS group which was 0.067 ± 0.028 (t = -10.535, P < 0.01). CD59 was also expressed in the two groups . In normal group, the expression of CD59 was 0.879 ± 0.005, significantly higher than that in CRS group which was 0.238 ± 0.034 (t = 83.416, P < 0.01).</p><p><b>CONCLUSIONS</b>The nasal mucosa in CRS patients showed low expression of CD55 and high expression of CD59. This mechanism may be involved in the occurrence of CRS.</p>
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Female , Humans , CD55 Antigens , Metabolism , CD59 Antigens , Metabolism , Flow Cytometry , Rhinitis , Metabolism , Sinusitis , MetabolismABSTRACT
OBJECTIVE@#To explore the application of endoscopic endonasal approach in surgery for skull base tumor.@*METHOD@#From August 2000 to February 2009, retrospective analyses were performed on clinical data of 21 patients with skull base lesions treated by endoscopic endonasal surgery. There were 3 chordoma, 6 olfactory neuroblastoma, 4 squamous cancer, 5 malignant melanoma, 1 mucoepidermoid carcinoma, 2 sphenoidal malignant adenoma.@*RESULT@#Total tumor removal was obtained in 21 cases,subtotal removal in 2 cases. With follow up of 24 to 108 months, 4 cases were recurred, 5 cases were dead. The complications included cerebrospinal fluid (CSF) leak in 2 patients, intracranial infection after the endoscopic surgery in 1 patient. In the two patients with CSF leak, one case cured by internal medicine and another cured by endoscopic surgery.@*CONCLUSION@#The endoscopic endonasal surgery could provide sufficient treatment for skull base tumor, and is a safe, minimally invasive and efficient procedure, but indication should be exactitude selected.
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Adult , Aged , Female , Humans , Male , Middle Aged , Chordoma , General Surgery , Endoscopy , Esthesioneuroblastoma, Olfactory , General Surgery , Nose , General Surgery , Retrospective Studies , Skull Base Neoplasms , General SurgeryABSTRACT
Objective To explore the possibility and effectiveness of minimally invasive osteotomy and cable osteosynthesis for the treatment of adolescent eubitus varus. Methods Eleven cases of adolescent cubitus varns(2 cases complicated with internal rotation of 10°)were treated with minimally invasive supracondylar wedged osteotomy to preserve the integrity of the contralateral codex and periosteum.Two screws were inserted above and below the fracture line.They were fixed with cable after the greenstick fracture and internal rotation were adjusted.Plastic bandage was applied for 1 week postoperatively before rehabilitation. Results Bone fractures healed in the 11 cases in 36.3 days averagely,without infection or nerve palsy.Before operation,the mean angles of varus,flexion and extension were 35°±5°,125°±10°and 10°±5°respectively.After a mean follow-up of 33.5 months,the mean valgus angle of the elbow was improved to 8°±2°(t=16.632,P<0.05),flexion to 130°±8°and extension to 8°±3°(P>0.05).Internal rotation deformity was also ameliorated in the 2 cases. Conclusion It is practical and effective to treat adolescent eubitus varus with minimally invasive osteotomy and cable osteosynthesis,for it can lead to stable fixation,short healing time,and does not affect the flexion and extension of the elbow joint.
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Objective To explore the treatment and clinical characteristic of posterior mini-incision surgery for the single segment of the lumbar disc herniation.Methods Clinical data of 260 cases with single segment lumbar disc herniation were analyzed retrospectively.Results Follow-up for 6 months to 5 years,with an average of 24 months.According to Nakai effect criteria,109 cases of excellent,good in 132 cases,17 cases of fair,two cases of poor,12 cases of cerebrospinal fluid leakage,2 cases of wound hematoma,one case of vertebral space infection,resulting in 92.7%.Conclusion Advantages of posterior mini-incision surgery for the single segment of the lumbar disc herniation are small incision,less trauma,shorter operative time,less bleeding,quick recovery and low costs.Stressed the need to accuratel position preoperation.
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Objective To evaluate the hinged external flxator in combination with internal fixation for treatment of old type B fractures of the distal humerus.Methods Eleven cases of old type B fractures of distal humerus treated in our department were studied retrospectively.They were treated with hinged external fixators in combination with internal fixation and evaluated according to Mayo elbow performance scores.Results All the patients were followed up for 10 to 18(mean, 12.5)months.The mean union time was 4.6(range, 3.5 to 6.0)months.The final range of flexion to extension of the elbow was 19.4°±6.5° to 124.2°±11.3°.The final ranges of pronation and supination were 72.8°±5.4° and 67.6°± 7.3°.By Mayo elbow performance scores, the post-operative functional outcome of the elbow was excellent in 5 patients, good in 4, and fair in 2.Conclusion The old type B fractures of distal humerus can be effectively treated with hinged external fixators in combination with internal fixation, for early rehabilitation and restoration of the elbow function can be facilitated.
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Objective To study the clinical effect of cohesive elastic bandage (CEB) after operative treatment of ankle fractures. Methods After surgery, 60 patients with ankle fracture were randomly as-signed to 2 even groups: CEB dressing group and common dressing group. Functional exercise started the next day after operation. Comparison was made between the 2 groups in drainage, displacement and swelling. Results In CEB dressing group, the volume of drainage was (34.6±18.1) mL, the rate of displacement 6.7%, and the swelling was slight in 21 patients, moderate in 5 and severe in 4. In common dressing group, the volume of drainage was (85.1±17.1) mL, the rate of displacement was 63.3%, and the swelling was slight in 7 patients, moderate in 12 and severe in 11. The differences were significance(P<0.05) . Conclusion Use of CEB after surgery for ankle fractures may alleviate swelling, reduce bleeding effectively, and benefit early functional exercise.
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Objective To explore the role of compound nerve conduit, made of nerve growth factors (NGF) encapsuled by biodegradable core-shell nanofibers through coaxial electrospinning, in regeneration of injured sciatic nerves in rats. Methods The compound nerve conduits were developed from the core-shell structured biodegradable nanofibers with P(LLA-CL) as a shell and BSA/NGF or BSA as a core through coaxial electrospinning. Seventy-two Sprague-Dawley rats were randomly divided into 4 even groups. The middle segments (10 mm) of the sciatic nerve were excised and the defects were repaired with sciatic nerve autograft (group A), with P(LLA-CL) conduit (group B), with PLLA-CL conduit and one injection of NGF (group C), and with P(LLA-CL)/NGF controlled-release conduit (group D), respectively. Morphologic and functional evaluations of nerve regeneration were done by gross observation, sciatic function index, neural electrophysiological examination, resumption rates of triceps weight, histological and ultrastructural observa-tion respectively in 1, 2, 3 months after the operation. Results Three months after the operation, although partial biodegradation and small cracks could be observed, conduits remained intact in outline. Based on the functional and histological observations, nerve regeneration, nerve fibers arrangement, myelination and nerve function reconstruction in the P(LLA-CL)/NGF controlled-release conduit (group D) were similar to those in nerve autograft (group A) and significantly superior to those in groups B and C (P<0.05). Conclusion As the P(LLA-CL)/NGF-controlled release conduit has favorable mechanical properties and biocompatibility, it can effectively promote regeneration of the sciatic nerve in rats.
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OBJECTIVE To find a way of reserving high quality phonation function after phonomicrosurgery for premalignant lesions of the larynx.METHODS There were 77 cases with leukoplakia or atypical hyperplasia of the vocal cord included in this study.They were all treated with phonomicrosurgical techniques as mucosal epithelium ablation or mucosal stripping by using CO_2 laser.Ten patients with laryngeal papilloma were excised by CO_2 laser.RESULTS Twenty three patients with leukoplakia or mild atypical hyperplasia of the vocal cord achieved a normal phonation within 2 months.The 44 patients with moderate and advanced hyperplasia need 3～5 months to recover the normal phonation.Phonation recovery of the 10 patients with laryngeal papilloma treated with CO_2 laser was better than patients treated with transcervical approach.CONCLUSION The CO_2 laser assisted phonomicrosurgery is a reliable method for management the premalignant lesions of the larynx, which not only can remove the lesions and also can restore good voice function.
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OBJECTIVE To explore the dry ears and improving the auditory level of postaural bipedicle musculo-periosteal flap to obliterate the mastoid cavity. METHODS 78 cases(ears) of chronic otitis media were treated with radical mastoidectomy,open-ended tympanoplasty and conchaplasty,and received mastoid plombabge by postaural bipedicle musculo-periosteal flap.RESULTS In 78 cases(ears),the time of dry ears were reduced to 10 or 15 days and the auditory level in 58 ears was impoved(17.2?4.9) dB after treatment.CONCLUSION The surgery with postaural bipedicle musculo-periosteal flap to plombabge the mastoid cavity can achieve the epithelization in the operation cavity more quickly,achieve a short duration to dry ear shortly and improve the auditory level.
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OBJECTIVE To evaluate the therapeutic effect of intranasal endoscopic surgery on inverted papilloma of the nasal cavity and paranasal sinuses in stage Ⅰ-Ⅲ. METHODS According to the staging system developed by John H.Krouse,30 cases with inverted papilloma in the nasal cavity and paranasal sinuses in stage Ⅰ-Ⅲ were analyzed retrospectively. All patients were treated by intronasal endscopic surgery and were followed up for 24 months. RESULTS The inverted papilloma was removed completely and no serious complications occurred. One case recurred at 10 month after surgery and pathologically proved to be cancerated. Another 2 case recurred at 6 and 7 month after surgery respectively. Recurred tumors were removed again, no recurrences occurred in the following up period. The recurrence rate was 10 % and canceration rate was 3.3 %. CONCLUSION Endoscopic surgery is an effective method in management of the inverting papilloma in nasal cavity and paranasal sinuses in stage Ⅰ-Ⅲ.