Clinical practice of transnasal endoscopic operation for retrobulbar lesions / 中华耳鼻咽喉头颈外科杂志

Objective@#To summarize the skill and experience of transnasal endoscopic operation for retrobulbar lesions.@*Methods@#Seven patients aged from 25 to 67 years old diagnosed as retrobulbar lesions who underwent transnasal endoscopic operation in Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital between January 2013 and October 2016 were retrospectively analyzed. Two males and five females were included in this study. Five patients underwent transnasal endoscopic operation via media rectus-inferior rectus space, with the other 2 cases via media rectus-superior rectus space.@*Results@#Total lesion removal was achieved in 6 of 7 patients, while 1 patient underwent subtotal removal of the lesion. The visual acuity and visual field improved in 3 cases. The pathological examination showed hemangioma(5 cases), bone cyst(1 case) and fibroma(1 case). All patients were followed up for 9 months to 4 years without complications such as eye movement disorder or blindness, except for 1 case with preoperatively proptosis occurred postoperatively transient diplopia. There was no recurrence in 6 patients with total lesion removal, and the patient underwent subtotal removal of fibroma did not undertake operation again.@*Conclusion@#Transnasal endoscopic operation for retrobulbar lesions is a minimally invasive, safe and effective operatiiv method, which could be taken via different surgical approaches according to the size and location of the lesion.

The applicated current situation and prospect of endoscopic minimally invasive cholecystolithotomy / 中国基层医药

Gallbladder stone is a common disease and frequently occurring disease in surgery.Laparoscopic cholecystectomy surgery is the main treatment for gallstones,but high complications and after cholecystectomy after biliary calculi induced colon cancer incidence,high risk factors,seriously affect the quality of life of patients.With the rapid development of endoscopy,endoscopic minimally invasive cholecystolithotomy has become a new method in the treatment of gallbladder stones,major complications of endoscopic minimally invasive cholecystolithotomy for the recurrence of cholecystolithiasis,cholecystectomy and comparison,significantly reduce the complications,and the preservation of gallbladder function,improve the the quality of life in patients.Grasp the surgical indications,regulate the operation and adjuvant drug treatment can reduce the recurrence of gallbladder stones.If it can further reduce the recurrence rate of stone,it will be expected to become a good gallbladder function in patients with gallbladder stones in the treatment of priority.

Combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study surgical techniques and clinical applications of the intranasal endoscopic combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment.@*METHOD@#A retrospective clinical analysis of 3 patients whose admitted for orbital floor fractures or medial wall fractures operated by the intranasal endoscopic middle meatus with expand prelacrimal recess-maxillary ainus approach surgical treatment was studied, and the treatment effects and the postoperative complications were analyzed.@*RESULT@#All patients had been followed up for 6 to 12 months. All cases of diplopia symptom were disappeared, enophthalmos were totally corrected, no cases of complication were found.@*CONCLUSION@#Endonasal endoscopic combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment have great and clear view. This approach with less tissue damage and high therapeutic effect makes the cost lower than other methods and complications will be decreased as well, it has a great advantage in the orbital fracture treatment.

Imaging classification for horizontal segment of uncinate process and its guiding significance in functional endoscopic sinus surgery / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore a new method for horizontal segment of uncinate process classification from image of nasal sinus.</p><p><b>METHODS</b>On the level of horizontal segment of uncinate process of nasal sinus high resolution CT (HRCT) coronal scan. A vertical line and a parallel line were drawn started from the fornix top of the inferior meatus and orbital floor. The uncinate process which suited in the 'Cross' regional was divided into four types by these lines. These were: intra-superior, intra-inferior and extra-superior, extra-inferior. According to this method, 119 patients with chronic sinusitis which were divided into these four types by the imaging classification for horizontal segment of uncinate process operated by functional endoscopic sinus surgery, and the treatment effects and the postoperative complications were analyzed.</p><p><b>RESULTS</b>These 119 chronic sinusitis patients (238 sides uncinated process) were divided into four types by the imaging classification for uncinated process. The amount of intra-superior types was 66.0% (157/238), the amount of intra-inferior types was 16.8% (40/238), the amount of extra-superior types was 13.9% (33/238), and the amount of extra-inferior types was 3.4% (8/238). Functional endoscopic sinus surgery was performed according to this classification. All maxillary sinus natural ostium were found. Two cases occured orbital board damage (one was intra-superior, the other was extra-inferior).</p><p><b>CONCLUSION</b>The imaging classification for horizontal segment of uncinate process demonstrates a guiding significance for us to predict the difficulty of the operation and prevent the complications.</p>

Prevalence of allergens for Changsha patients with allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the allergens in patients with allergic rhinitis, to find common allergens of Changsha and to provide statistic basis for a reasonable prevention and treatment.@*METHOD@#The allergens in 1437 patients with allergic rhinitis in Changsha were detected by skin prick test.@*RESULT@#Eight hundred and ninety-eight (62.49%)of 1437 cases presented positive reaction. Among positive cases in inhalation group, the most common allergen was flour mite (98.33%), then were house dust mite (94.54%), mycetes II (19.27%) and weed (18.37%). Shrimp (35.41%) was the most common allergens in food group. And in childhood, adolescence and adulthood prick-positive cases, the ratio of more than 2 positive allergens were about 8.57%,18.04%, 19.15%.@*CONCLUSION@#The study shows that the flour mite and house dust mite are the most common allergens in Changsha.

Analysis of imaging characteristics of B-cell non-Hodgkin lymphoma of skull base (reports of 2 cases) / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the imaging characteristics of B-cell non-Hodgkin lymphoma of skull base.@*METHOD@#Two patients with B-cell non-Hodgkin lymphoma of skull base in our hospital were reported, meanwhile the imaging characteristics were summarized and analyzed with the related literature.@*RESULT@#The imaging feature of B-cell non-Hodgkin lymphoma of skull base was equal or low signal on MR T2-weighted and not obviously enhanced. The width of the soft tissue invaded in intracalvarium appeared much bigger than the width of bone destruction, and the lesion infiltrated along the dural surface.@*CONCLUSION@#Characteristic imaging appearance of B-cell non-Hodgkin lymphoma of skull base have the significance in diagnosis and differential diagnosis.

Transnasal endoscopic reconstruction of the nasal-skull base defect to manage the cerebrospinal fluid leaks with intranasal autologous grafts / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the methods and feasibility of the transnasal endoscopic reconstruction of the nasal-skull base defect to manage the cerebrospinal fluid leaks using intranasal autologous grafts.@*METHOD@#Ninety six nasal-skull base defect patients with cerebrospinal fluid leaks were managed under endoscope with intranasal autologous materials. The repair materials and methods for the management of the cerebrospinal fluid leaks were tailored based on the different location and size of nasal-skull base defect. Eighteen cases with nasal-skull base defects less than 0.5 cm in diameter were repaired by an overlay technique using free mucoperiosteal graft from the middle turbinate. Thirty five patients with defects in the ethmoid roof and ethmoid plate ranging in size from 0.5 to 1.0 cm in diameter were repaired by an overlay technique using a pedicled middle turbinate flaps. Twelve cases with defects in the sellar clivus ranging in size from 0.5 to 1.0 cm in diameter were repaired by an overlay technique using a pedicled septal mucoperiosteal grafts. Nineteen cases with a diameter of 1.0 to 1.5 cm defects were repaired using free septal cartilage and mucoperiosteal grafts. Seven cases with defects in the ethmoid roof and ethmoid plate ranging from 1.5 to 2.5 cm in diameter were repaired using a pedicled middle turbinate and ethmoid plate flaps. Five sellar clival defect cases ranging from 1.5 to 2.5 cm in diameter were repaired using ethmoid plate and pedicled septal mucoperiosteal flaps.@*RESULT@#Six months to 6 years' follow up indicated that two patient developed postoperative cerebrospinal fluid leaks one year and two years after operation, respectively. One was successfully managed by conservative treatment. The other was successfully repaired by second surgery. Three patients developed transient postoperative cerebrospinal fluid leak that was spontaneous recovered without special treatment. No other new postoperative cerebrospinal fluid leaks occurred.@*CONCLUSION@#We concluded that transnasal endoscopic reconstruction of the nasal-skull base defect is a highly effective method for managing the cerebrospinal fluid leak with the advantage of easily obtaining the intranasal autologous materials. The autologous materials should be varied based on different size and location of the skull base defects.

Study on the Expression of LMP1,CyclinD1 and Bcl-2 in Nasopharyngeal Carcinoma and Its Clinical Significance / 中国医师杂志

Objective To investigate LMP1,CyclinD1 and Bcl-2 expression in nasopharyngeal carcinoma(NPC) and its clinical significance,and analyze their relation. Methods LMP1,CyclinD1 and Bcl-2 expression was assayed respectively in 60 NPC tissues by immunohistochemical method. Results ⑴The positive expression rates of LMP1,CyclinD1 and Bcl-2 in NPC were 65%(39/60), 60%(36/60)and 65%(39/60) respetively; ⑵The mean survival period, the five-year survival rate and median survival period in the NPC patients with LMP1, cyclinD1 and Bcl-2 positive expression were significantly shorter than those in the NPC patients with LMP1, cyclinD1 and Bcl-2 negative expression (P