Effects of FasL inhibitors on corneal apoptosis and Treg after corneal transplantation in rats / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To explore the effect of intravitreal injection FasL inhibitors on corneal apoptosis, Fas, FasL expression, Treg numbers in blood and lymph nodes and rejection index in rats after corneal transplantation.METHODS:A total of 24 SD rats(24 eyes)who received penetrating keratoplasty were randomly divided into two groups: PBS group received intravitreal injection of PBS(12 rats, 12 eyes)and FasL inhibitor group(12 rats, 12 eyes). Rejection index was recorded every week and blood samples and lymph node were collected at 1, 3 and 5wk after surgery to analyze the proportions of Treg. Corneal tissue was collected for detecting the expression of Fas and FasL and number of apoptosis.RESULTS: The expression of Fas, FasL in FasL inhibitor group decreased significantly compared with the PBS group(all P<0.05); Corneal cell apoptosis significantly decreased in FasL inhibitor group, and it was the lowest at 5wk after surgery; Treg numbers in blood and lymph nodes significantly increased in FasL inhibitor group at 3wk after surgery(all P<0.05); rejection index of corneal transplantation in the FasL inhibitor group was significantly lower than that of PBS group(all P<0.05).CONCLUSION:Intravitreal injection of FasL inhibitors after corneal transplantation could reduce the apoptosis in all layers of cornea, increase the number of Tregs in blood and lymph nodes, and alleviate rejection.

The efficacy of hemostatic powder for chronic rhinosinusitis in endoscopic sinus surgery: a prospective, randomised, controlled and single blinded clinical trial / 中华耳鼻咽喉头颈外科杂志

Objective: To study the efficacy and patient comfort of absorbable hemostatic powder after endoscopic sinus surgery (ESS). Methods: A total of 21 (17 males, 4 females) patients with an average age of 42(ranging from 18 to 65) underwent bilateral ESS for chronic rhinosinusitis(CRS) in Beijing Tongren Hospital, Capital Medical University between October 2015 and July 2019 were enrolled to compare the effect of absorbable hemostasis powder with Nasopore using an intrapatient control design. A randomized controlled trial was conducted in the left and right nasal cavities of the same patient. If hemostatic powder was applied in the experiment nasal cavity, the Nasopore was applied in the control nasal cavity. The mean preoperative sinus computed tomography (CT) score was 6.25. All patients competed for symptom diaries using a visual analog scale (VAS, score out of 10) at baseline, through 1, 7, 14 and 30 days. Outcomes including bleeding, facial pain, nasal obstruction, nasal discharges using VAS were recorded separately for both sides. Postoperative endoscopic scores were also investigated. SPSS 22 and Graphpad prism 8.0 statistical softwares were used for the analysis. Paired t-test or nonparametric test was used between the test side and the control side. The difference was statistically significant (P<0.05). Results: The bleeding score and total nasal symptom VAS scores at postoperative days (POD) 1, 7, 14 and 30 were not significantly different(t=1.341, 0.552, 0.631, 0.158, all P>0.05;t=0.944, 1.471, 1.612, 2.251, all P>0.05). There was no significant difference between absorbable hemostasis powder and Nasopore side on POD 1, 7, 14 and 30 in terms of each nasal symptom VAS scores(all P>0.05). On POD 1, 7 and 14, the packing material degeneration scores of the absorbable hemostasis powder side were significantly lower than those of the Nasopore side [(1.33±0.21)vs(2.00±0.00),(0.38±0.18) vs (1.95±0.22), 0 vs (1.80±0.13), all P<0.01]. There were significant differences between absorbable hemostasis powder and Nasopore side on POD 1, 7, 14 and 30 in terms of endoscopic scores (edema, crusting, discharges, scar, polyps and material degeneration, t=3.07, 7.00, 6.41, 2.69, all P<0.05). Conclusions: The absorbable hemostasis powder and Nasopore has similar postoperative hemostasis effect. The absorbable hemostasis powder is rapidly cleared and without negative effects on mucosal wound healing 14 days postoperatively.

Correlation analysis of reject reaction and corneal endothelial cells after penetrating keratoplasty from donation after cardiac death / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To study the relativity between reject reaction from donation after cardiac death (DCD) and corneal endothelial cell source of corneal graft after penetrating keratoplasty.METHODS:Totally 28 cases of corneal graft rejection after penetrating keratoplasty with cardiac death donor cornea were analyzed using corneal endothelial microscope at less than 1mo,2-3mo,4-6mo,7-12mo after operation.RESULTS:Coefficient variation of corneal endothelial cell of the 28 cases at less than 1 mo,2-3mo,4-6mo and 7-12mo were 38.23％,49.56％,57.18％,65.04％.Corneal endothelial cell density were 2071.15 ± 311.47,1771.33 ± 348.18,1626.59±353.92,1553.14±307.31.The coefficient variation of corneal endothelial cells was positively correlated with rejection (r =0.95,P ＜ 0.05).The postoperative corneal endothelial cell density was negatively correlated with rejection (r=-0.93,P＜0.05).CONCLUSION:The corneal endothelial cell coefficient variation increased gradually and the corneal endothelial cell density decreased gradually after DCD corneal allograft rejection.Corneal endothelial cell coefficient variation and corneal endothelial cell density can be used as indicators of early detection of postoperative rejection.

Comparison of small - incision cataract surgery and phacoemulsification / 国际眼科杂志(Guoji Yanke Zazhi)

?AlM: To compare the clinical effect between small-incision cataract surgery and phacoemulsification. ?METHODS: Totally 93 patients ( 124 eyes ) with age-related cataract who received treatment in Mar 2010 and Feb 2013 were dicided into 2 groups randomly. Forty-two patients ( 59 eyes ) in group small - incision cataract surgery ( SlCS ) were treated by SlCS, while other 51 patients ( 65 eyes ) in group Phaco were treated by phacoemulsification. And then, postoperative visual acuity, corneal astigmatism, surgically induced astigmatism ( SlA ) and intraoperative and postoperative complications were contrasted between groups. ?RESULTS: After 1d and 1wk of postoperation, there were 38 eyes ( 64. 4%) and 41 eyes ( 69. 5%) having a better visual acuity of 0. 5 in the SlCS group, while there were 29 eyes (44. 6%) and 32 eyes (49. 2%) in the Phaco group. The vision of SlCS group was better than that of Phcao group (χ2 = 4. 877, 5. 242, P 0. 05). The average corneal astigmatism used analysis of repeatedly measuring designing variance: Comparing the corneal astigmatism in intra - groups at different times, it was statistically significant (F=25. 624, P0. 05). The coneal astigmatism of each group was higher at 1wk after the surgery than that of preoperation, and the contrast had statistical sigenficence (t=2. 906, 2. 427, P0. 05). There were statistical differences in SlA at different time both by intra-group comparison and group comparison ( F=26. 37, P ?CONCLUSlON: Our research shows that small-incision cataract surgery and phacoemulsification had similar effect in the treatment of cataract. Phacoemulsification is not the only surgery option for the best treatment effect. Small- incision cataract surgery can be popularized in basic- level hospitals, achieving the effect similar to phacoemulsification.

Use of indocyanine green staining technique for phacoemulsification in white cataract / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the application efficiency of 5g/L indocyanine green ( ICG ) staining technique for continuous circular capsulorhexis ( CCC ) during phacoemulsification in white cataract. METHODS:Ninety-eight patients (98 eyes) with white cataract were randomly divided into staining group ( 50 cases, 50 eyes) and control group (48 cases, 48 eyes). The control group didn't do anterior capsule staining. The staining group was injected to fill the anterior chamber, 5g/L ICG 0.1mL was applied on the central surface of the anterior capsule, using a 27G blunt needle through the side-port after 30s, and the redundant ICG was replaced by BSS, and continuous curvilinear capsulorhexis was accomplished using capsulorhexis forceps. RESULTS: In staining group: after ICG staining, the capsule, which presented uniform light green and visualization of the anterior capsule was significantly improved. There are 48 eyes capsulorhexis success. The rate of success was 96%. Meanwhile, in control group, there was 29 eyes capsulorhexis success. The rate of success was 60%. The difference was statistically significant (P CONCLUSION:Indocyanine green staining increases the visibility of anterior capsule in over mature cataract, and it should be an effective and helpful method which can increase the success rate of capsulorehxis. At the same time, it can reduce the incidence of intraoperative complications. This will help beginners quickly grasp continuous curvilinear capsulorhexis, and shorten the learning curve.

The role of peripheral blood eosinophil percentage in classification of chronic rhinosinusitis with nasal polyps / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Trying to find a useful marker to subclassify chronic rhinosinusitis (CRS), ratio of eosinophil in peripheral blood was investigated.</p><p><b>METHODS</b>Histologic characteristics of surgical samples were analyzed in 119 CRS with nasal polyps (CRSwNP) patients, who were classified into eosinophil CRSwNP (ECRSwNP) group and non-ECRSwNP group. Peripheral blood eosinophil percentage, olfactory function, skin prick test, serum total IgE and sinus CT scan in two groups were all examined and analyzed. To evaluate the discriminatory power of eosinophil to diagnose ECRSwNP, the Receiver Operating Characteristic(ROC)curve was analysed.</p><p><b>RESULTS</b>There were significant differences in Ratio of EOS, serum total IgE, and olfactory function scores, between ECRSwNP group and non-ECRSwNP group(mean value were 7.31%: 3.90%, 60.9 IU/L: 28.9 IU/L, 5.8: 0.4 respectively, U value were 620.01, 1020.53 and 1092.52, respectively, all P < 0.05). However, there was no difference in skin prick test between two groups. In CT scan exam, there were no differences in Lund-Mackay scores in frontal sinus, anterior ethmoid sinus, posterior ethmoid sinus, sphenoid sinus and ostiomeatal complex area, but maxillary sinus, between ECRSwNP group and non-ECRSwNP group (U value were 27.5, 23.5, 22.5, 31.5, 28.5, respectively, all P > 0.05, and U value of maxillary sinus was 12.01, P < 0.05 ). Peripheral blood eosinophil percentage and serum total IgE were related with pathology of nasal polyps (r value were 0.55, 0.24, and P value were 0.001, 0.01, respectively), especially blood eosinophilia can be a predictor of ECRSwNP. The area under curve was 0.818 and cutoff value was 5.65%.</p><p><b>CONCLUSIONS</b>ECRSwNP is different from non-ECRSwNP in many clinical features. Peripheral blood eosinophil percentage is consistent with histologic features of ECRS, which is a useful marker as 5.65% in classification of CRS.</p>

Analysis of transforming growth factor β signaling in chronic rhinosinusitis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It has been reported that there is a significant difference in the local tissue concentration of transforming growth factor (TGF)-β1 between chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis without nasal polyps (CRSwNP) patients. TGF-β has been reported to play an important role in regulating epithelial cell repair in lower airway remodeling and may be a critical factor involved in the remodeling process of chronic rhinosinusitis (CRS).</p><p><b>METHODS</b>Ethmoidal mucosal samples collected from CRS and healthy control patients were analyzed for TGF-β1, TGF-β receptor I, TGF-β receptor II, Smad3, phospho-Smad3, Smad7, and Smad anchor for receptor activation by Western blotting analysis. The proliferation of sinonasal epithelial cells at baseline and after TGF-β1 and/or EGF stimulation was evaluated by the MTT assay.</p><p><b>RESULTS</b>In CRSsNP, TGF-β1, TGF-β receptor I, TGF-β receptor II, and Smad3 protein levels were significantly higher than controls. In CRSwNP, TGF-β1, Smad3, and pSmad3 protein levels were significantly lower than controls. Smad7 protein was significantly higher in CRS than controls. In vitro experiments demonstrated that the baseline proliferation levels of sinonasal epithelial cells were lower in CRS than controls.</p><p><b>CONCLUSIONS</b>CRSwNP is characterized by a lower level of TGF-signaling compared with the control. In CRSsNP, although the upstream signaling of TGF-β was enhanced, the high Smad7 protein expression may restrain the downstream signaling components (e.g., pSmad3) and the TGF-β antiproliferative effect on sinonasal epithelium. The difference in the local tissue concentration of TGF-β1 between CRSsNP and CRSwNP patients did not result in significant differences in epithelial proliferation.</p>

Removal of Schwannoma in the pterygopalatine and infratemporal fossa via endoscopic prelacrimal recess approach / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To sum up and analyze the results of surgical removal of Schwannoma in the pterygopalatine and infratemporal fossa (PPF and ITF) through postero-lateral wall via prelacrimal recess approach (PLRA). The surgical technique and indications were presented and discussed.</p><p><b>METHODS</b>Six patients aged from 29-59 year-old with Schwannoma in the PPF and ITF, who received the tumor resection via PLRA under endoscope, were enrolled in this paper. Three were female and 3 were male. All of them received preoperative CT and MRI. The PPF and ITF were approached via prelacrimal recess endoscopically under general anesthesia. Schwannoma was histopathologically confirmed after surgery. The postoperative periodical CT and MRI follow up was conducted.</p><p><b>RESULTS</b>The tumors were removed completely in these 6 patients. No recurrence was found during 19.3 months follow up on the average. Three patients had obvious numbness in the V2 innervation area 1 or 2 weeks after operation and disappeared afterwards. Only 1 patient had mild altercation numbness at the end of follow up.</p><p><b>CONCLUSIONS</b>Schwannoma involved PPF and ITF can be removed endoscopically via PLRA. The lateral wall of nasal cavity might be kept intact. It is a novel minimally transnasal invasive approach to PPF and ITF with less damage and complications.</p>

CT and MRI diagnosis of lesions in unilateral maxillary sinus / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the CT and MRI findings of lesions in unilateral maxillary sinus, and to compare the effect of CT and MRI in the differential diagnosis of lesions in unilateral maxillary sinus.</p><p><b>METHODS</b>Retrospective analysis of CT and contract-enhanced MRI imaging data from 34 patients with lesions in unilateral maxillary sinus which were diagnosed by endoscopic sinus surgery and postoperative pathology. The CT and contract-enhanced MRI's value in the differential diagnosis in lesions in unilateral maxillary sinus was analysed.</p><p><b>RESULTS</b>All 34 patients had unilateral maxillary sinus lesions. On CT: soft tissue density shadow in the unilateral maxillary sinus was found in all 34 cases. Five cases showed spot high density with thickening bone in the maxillary sinus wall. Eleven cases showed expansion of the opening of maxillary sinuses. Two cases showed broken lateral wall of nasal cavity . One case showed soft tissue density shadow in the maxillary sinus with curve edge with high density shadow which had a tooth shadow in it. Other 14 cases showed only soft density shadow in the maxillary sinuses. On MRI: all 34 cases revealed lower signals on T1WI compared to gray matter. Little loss signal were found in the inner of the maxillary sinus fungal balls on T1WI. Enhanced MR imaging showed no enhanced in nasal sinusitis, sinus cysts and polyp of posterior naris. In homogenous enhancing and "the cerebral convolution sign" were found in the hemorrhagic and necrotic nasal polyp, the nasal inverted papilloma and the malignant tumor cases. Higher signals were seen in the nasal sinusitis, fungal balls and the polyp of posterior naris cases on T2WI. In homogenous signal with different levels were found in the hemorrhagic and necrotic nasal polyp, the nasal inverted papilloma and the malignant tumor cases on T2WI.</p><p><b>CONCLUSIONS</b>CT and MRI examination are important in the diagnosis of the unilateral maxillary sinus lesions. Both CT and MRI had more differential diagnostic value in the unilateral maxillary sinus lesions than only CT used.</p>

Clinical application of Draf IIb frontal sinusotomy and it's modified procedures / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To summarize the follow-up outcomes of Draf IIb frontal sinusotomy and it's modified procedures, and to discuss the surgical indications and prognostic factors.</p><p><b>METHODS</b>Thirty-two patients treated between 2004 and 2010 were enrolled in this study. There were 15 patients for recurrent frontal inverted papilloma (IP), 6 for mucocele, 4 for recurrent frontal sinusitis, 3 for osteoma, 2 for meningoencephalocele with cerebrospinal fluid rhinorrhea, 1 for meningoencephalocele alone and 1 for acute frontal sinusitis. All patients underwent preoperative paranasal sinus computed tomography (CT) scans. Patients with tumor accepted magnetic resonance imaging (MRI). The patients with meningoencephalocele and cerebrospinal fluid rhinorrhea received magnetic resonance cisternography (MRC). The Draf IIb frontal sinusotomy and it's modified Draf IIb-1-3 procedures were applied endoscopically under general anesthesia mainly by high speed bur and power system. The postoperative CT scan was obtained as a base line for follow-up 1 week after the operation. Postoperative follow-up was performed under endoscope.</p><p><b>RESULTS</b>Among 19 cases of Draf IIb, 12 were recurrent IP of frontal sinus, 4 were mucocele, 2 were recurrent frontal sinusitis and 1 were osteoma. Five cases received Draf IIb-1, 2 for each recurrent IP of frontal sinus and recurrent frontal sinusitis and 1 for osteoma. Six cases received Draf IIb-2, 3 for meningoencephalocele, 1 for each IP, acute frontal sinusitis and osteoma. Two cases received Draf IIb-3 were mucocele. The follow-up ranged from 8 to 73 months. Twenty-two cases of the frontal nepostium were widely opened, 7 were stenosis and 3 were closed. Revision surgery was seen in 2 cases with IP. All of them had no complications.</p><p><b>CONCLUSIONS</b>The Draf IIb frontal sinusotomy and it's modified procedures are suitable for complex frontal sinus disease, which can be selected according to pathological and anatomical features, and have a good prospect for clinical application.</p>

Pharyngeal aerodynamic characteristics of obstructive sleep apnea/hypopnea syndrome patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The role of nasal obstruction in the pathogenesis of obstructive sleep apnea/hypopnea syndrome (OSAHS) has been debated for decades. In this prospective study, we compared the pharyngeal aerodynamic characteristics of OSAHS patients and normal people, and investigated the contribution of total nasal airway resistance to the pathophysiology of OSAHS.</p><p><b>METHODS</b>Computational fluid dynamics (CFD) was used to extract the average pressure and average airflow velocity in three transverse cross-sectional planes of the pharynx for statistical analysis, and the correlation between nasal resistance and the average pressure in the pharyngeal cavity was investigated.</p><p><b>RESULTS</b>The negative pressure within the pharyngeal cavity was significantly higher in OSAHS patients than in normal subjects, and total nasal airway resistance correlated well with the average pressure in three consecutive transverse cross-sections of the pharyngeal cavity.</p><p><b>CONCLUSIONS</b>Greater negative pressure within the pharyngeal cavity contributed to the increased collapsibility of the pharynx in OSAHS patients, and the strong correlation between nasal resistance and pharyngeal pressure suggests that the nose plays a role in the pathogenesis of OSAHS.</p>

Comparison of posterior capsular opacification models by phacoemulsification with or without intraocular lens implantation in rabbit / 中华实验眼科杂志

Background Prevention and treatment of posterior capsular opacification (PCO) is a hot issue.To establish a PCO animal model is the basis of relevant studies.The most common methods of creating a PCO model are phacoemulsification surgery with or without intraocular lens (IOL) implantation.But the suitability of different methods is unclear.Objective This experiment was to compare the outcome between the two methods of establishing a PCO model in rabbit eyes.Methods Twenty New Zealand white rabbits were collected and randomized into 2 groups.Phacoemulsification of cataract with IOL or without IOL implantation was performed on the right eyes of rabbits in these two groups.The operative eyes were examined under the slit lamp from day 1 through 3 months after surgery.The inflammatory response was evaluated and compared between the two groups,and the extent of PCO was graded based on Odrich's criteria.The use of the animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The inflammatory response,including conjunctival congestion,corneal edema and aqueous flare were less severe in the model eyes with IOL implantation than the eyes without IOL implantation 1-3 days after operation.Inflammatory response gradually disappeared and showed the same degree in the PCO grade from 2 weeks through 3 months in both groups.The numbers of eyes with 1-3 grade of PCO were 8 and 9,and those with 0 grade of PCO were 2 and 1 in the with IOL implantation group and without IOL implantation group,respectively,showing a significant difference (P=0.39).PCO appeared at 1 month,extended at 2 months and formed dense fibrosis following operation.Conclusions The model outcome of phacoemulsification combined with IOL implantation is better than without IOL implantation one.It is the ideal animal model for the study of after cataract.

Endoscopic management of the inverted papilloma involving frontal sinus and its drainage pathway / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The endoscopic management of inverted papilloma has gained increasing popularity over the last 15 years. However, the appropriate management of lesions involving the frontal sinus and its drainage pathway still has to be determined.</p><p><b>METHODS</b>We performed a retrospective review of the results of the patients with inverted papilloma in the Otolaryngology Head and Neck Surgery department, Beijing Tongren Hospital from 2004 to 2007 to identify the patients with lesions involving frontal sinus and its drainage pathway. By its appearance on nasal endoscopic examination and CT scanning, the tumors were defined using Krouse staging system. Sinus endoscopy was used to screen for disease after endoscopic resection. And their clinical outcomes were analyzed.</p><p><b>RESULTS</b>A total of nine patients (8 males and one female) with inverted papilloma who had frontal sinus and its drainage pathway involvement were identified. All tumors were defined as T3 lesions. Preoperative and postoperative pathologic examinations revealed inverted papilloma as the diagnosis. Four cases with lateral wall of frontal recess attachment underwent endoscopic Draf II A frontal sinusotomy. Three cases with either lateral and posterior walls of frontal recess and frontal infundibulum attachment or medial and posterior walls of frontal recess and frontal infundibulum attachment underwent Draf II B procedure. Two cases with either posterior wall of frontal recess and frontal infundibulum attachment or medial, lateral and posterior walls of frontal recess and frontal infundibulum attachment underwent Draf III procedure. All patients remain disease free with an average follow-up of 13 months.</p><p><b>CONCLUSIONS</b>Extensive inverted papilloma (Krouse T3 lesions) can be treated successfully with an endoscopic approach.</p>

Evidence of bacterial biofilms in chronic rhinosinusitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To observe the presence of bacterial biofilms in mucosal specimens in patients operated for chronic rhinosinusitis.</p><p><b>METHODS</b>A total of 12 subjects undergoing endoscopic sinus surgery were included. The control group was 6 patients with obstructive sleep apnea-hypopnea syndrome. Six patients with chronic rhinosinusitis were enrolled in the study group. Mucosa of uncinate process, ethmoid bulla or maxillary sinus was obtained during endoscopic sinus surgery. All the samples were prepared using standard methods for scanning electron microscopy. Patients' information such as age, gender, symptoms, sinus CT, endoscopic examination, skin prick test were recorded in detail.</p><p><b>RESULTS</b>Standard-preparation scanning electron microscopy displayed denuded epithelium and disarrayed cilia in chronic rhinosinusitis patient's mucosa. In the study group, bacterial biofilms of different morphology were seen in five samples; One sample showed filamentous structure like fungi. Using strict scanning electron microscopy morphologic criteria, 83.3% samples in the study group were found to have micrographic evidence of biofilms. No bacterial biofilms were detected in the control group.</p><p><b>CONCLUSIONS</b>In the patients undergoing surgery for chronic rhinosinusitis, different degree of mucosal injury could be found. Bacteria biofilms of different life stages were demonstrated to be present. No bacterial biofilms were detected in the control group.</p>

Spiral computed tomography analysis of fronto-ethmoidal cells in normal subjects / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The purpose of this study was to determine the prevalence of frontoethmoidal cells in normal Chinese subjects.</p><p><b>METHODS</b>Two hundred and two Chinese subjects without symptoms of frontal sinus disease were undergone spiral computed tomography (CT). The multiplanar reconstruction images were evaluated using a standard triplanar reconstruction protocol on a computer workstation.</p><p><b>RESULTS</b>There were 121 males and 81 females. The mean age was (39.4 +/- 13.5) years. Of all the frontal cells identified in 159 sides (39.4%) of frontal recesses, the prevalence of type I, type II, type III and type cells were 24.3% (98 sides), 6.9% (28 sides), 8.2% (33 sides) and 0% (0 side) respectively. Suprabulbar cell, supraorbital ethmoid cells, and frontal bulbar cell were identified in 148 sides (36.6%) Jian-hu, 22 sides (5.4%), and 36 sides (8.9%) respectively. While the interfrontal septal cells was found in 25 patients (12.4%). The prevalence of agger nasi cell was 94. 1% (380 sides). Two hundred and forty-four uncinate processes (60.4%) had one superior attachment for each uncinate process; the other 160 uncinate processes (39.6%) had two superior attachments for each uncinate process. The single superior attachment of the uncinate process into the surrounding structures was identified to have the following distribution: 53.0% (n=214) to the lamina papyracea, 5.2% (n=21) to the middle turbinate, 2.2% (n=9) to the skull base. Most of the uncinate process' two superior attachments were either into the lamina papyracea and the skull base (27.5%, n=111) or into the lamina papyracea and the middle turbinate (8.7%, n=35). The other 14 uncinate processes (3.5%) superiorly attached to the skull base and the middle turbinate. The prevalence of recessus terminalis was 89.1% (n=360).</p><p><b>CONCLUSION</b>The result demonstrated the normal frontal recess pneumatization patterns in normal Chinese.</p>

CT evolution of nasal steroid management of chronic rhinosinusitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of topical steroid treatment of nonpolypoid chronic sinusitis.</p><p><b>METHODS</b>Two cohorts of adult and children with nonpolypoid chronic sinusitis were investigated. The first cohort consisted of 11 pediatric patients [mean age, (11.8 +/- 3.2) years] with a mean Lund score of 10.3 +/- 5.7 (x +/- s). The second cohort consisted of 13 adult patients [mean age, (36.7 +/- 11.0) years] with a mean Lund score of 12.2 +/- 5.7. The mean duration of the nasal budesonide (Rhinocort) treatment was (7.5 +/- 3.2) weeks for adult patients (256 microg/d) and (7.0 +/- 3.4) weeks for pediatric patients (128 microg/d). Each Lund score and the patient's assessment of nasal symptoms were evaluated after treatment.</p><p><b>RESULTS</b>The average Lund score was significantly decreased to 6.5 -/+ 7.5 (t = 3.82, P < 0.01) in adult patients and to 2.6 +/- 3.7 (t = 5.08, P < 0.01) in pediatric patients after treatment. Thirty-eight percent of the adult patients and 73% of the pediatric patients were cured on CT images. The patient's self-assessment of efficacy was positively correlated with pretreatment Lund score in adult patients (r = 0.676, P < 0.05), but not so in pediatric patients.</p><p><b>CONCLUSIONS</b>These findings demonstrate that most of patients with nonpolypoid chronic sinus did well with topical steroid treatment. Therefore, surgery was required in few patients.</p>