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INTRODUCTION: The aim of this study was to summarize the incidence, risk factors, and prognostic factors of distant metastasis of sinonasal carcinoma. METHODS: We collected data for patients diagnosed with sinonasal carcinoma from 2010 to 2015 from the SEER database and analyzed the risk factors for distant metastasis via univariate and multivariate logistic regression analysis. In addition, univariate and multivariate Cox regression analysis models were used to describe the factors related to the overall survival of patients with distant metastasis. RESULTS: A total of 2,255 patients were included in the study, including 86 in the distant metastasis group and 2,169 in the nondistant metastasis group. In the univariate and multivariate logistic regression analyses, we found that the risk factors affecting distant metastasis were poorly differentiated tumor grade (HR = 1.932, 95% CI: 1.082-3.452, p = 0.026), advanced T stage (T3-T4) (HR = 4.302, 95% CI: 2.047-9.039, p < 0.001), and advanced N stage (HR = 3.093, 95% CI: 1.911-5.005, p < 0.001). Moreover, elderly patients had a poorer prognosis than young patients (HR = 1.792, 95% CI: 1.096-2.931, p = 0.02) and that surgical treatment improved the survival rate of tumor patients with distant metastasis (HR = 0.450, 95% CI: 0.247-0.821, p = 0.009). CONCLUSION: Tumor grade, T stage, and N stage are risk factors for distant metastasis in sinonasal carcinoma, while an age of less than 65 years and surgery were positive prognostic factors for sinonasal carcinoma patients with distant metastasis.
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Carcinoma , Neoplasias de los Senos Paranasales , Humanos , Anciano , Estadificación de Neoplasias , Pronóstico , Factores de RiesgoRESUMEN
Background: Accurate forecasting of the risk of death is crucial for people living with head and neck mucosal melanoma (HNMM). We aimed to establish and validate an effective prognostic nomogram for HNMM. Methods: Patients with HNMM who underwent surgery between 2010 and 2015 were selected from the Surveillance, Epidemiology, and End Results (SEER) database for model construction. After eliminating invalid and missing clinical information, 288 patients were ultimately identified and randomly divided into a training cohort (199 cases) and a validation cohort (54 cases). Univariate and multivariate Cox proportional hazards regression analyses were performed in the training cohort to identify prognostic variables. Independent influencing factors were used to build the model. Through internal verification (training cohort) and external verification (validation cohort), the concordance indexes (C-indexes) and calibration curves were used to evaluate the predictive value of the nomogram. Results: For the training cohort, five independent risk predictors, namely age, location, T stage, N stage, and surgery, were selected, and nomograms with estimated 1- and 3-year overall survival (OS) and cancer-specific survival (CSS) were established. The C-index showed that the predictive performance of the nomogram was better than that of the TNM staging system and was internally verified (through the training queue: OS: 0.764 vs 0.683, CSS: 0.783 vs 0.705) and externally verified (through the verification queue: OS: 0.808 vs 0.644, CSS: 0.823 vs 0.648). The calibration curves also showed good agreement between the prediction based on the nomogram and the observed survival rate. Conclusion: The nomogram prediction model can more accurately predict the prognosis of HNMM patients than the traditional TNM staging system and may be beneficial for guiding clinical treatment.
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Objective:To investigate the effect of orofacial myofunctional therapy on the clinical efficacy of upper airway surgery for adults with severe obstructive sleep apneaï¼OSAï¼. Methods:A total of 48 patients with OSA who underwent upper airway surgery in the Shenzhen Second People's Hospital from June 2020 to September 2021 were included in this study. These patients were randomly divided into the combination groupï¼21 casesï¼ and the surgery groupï¼27 casesï¼. The effective rate, AHI, minimum blood oxygen saturation, snoring events and Epworth sleepiness scale scores at 6 months after operation were compared and analyzed between the two groups. Results:The proportions of AHI, LSaOî2, snoring events, and total snoring time in the combined group at 6 months after operation wereï¼14.77±9.15ï¼ times/h, ï¼81.19±6.52ï¼%, ï¼172.43±73.67ï¼ times, andï¼13.16±6.02ï¼%. The proportion of AHI, LSaOî2, snoring events, and total snoring time in surgical group at 6 months after operation wasï¼23.87±10.6ï¼ times/h, ï¼80.78±4.88ï¼%, ï¼235.81±83.23ï¼ times, ï¼17.58±5.94ï¼%. Compared with preoperative 6 months after operation, the proportion of AHI, snoring events, and total snoring time was significantly decreased, and LSaOî2was significantly increased, and the differences were statistically significantï¼P<0.05ï¼. The time of snoring and the proportion of snoring to time were significantly improved compared with those in the simple operation group, and the differences were statistically significantï¼P<0.05ï¼. Conclusion:This study verified that orofacial myofunctional therapy can improve the clinical efficacy after upper airway surgery for adults with severe obstructive sleep apnea.
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Apnea Obstructiva del Sueño , Ronquido , Humanos , Adulto , Ronquido/cirugía , Apnea Obstructiva del Sueño/terapia , Terapia Miofuncional , Polisomnografía , NarizRESUMEN
We evaluated the outcomes of resection of small acoustic neuromas using the transcanal transvestibular endoscopic approach. Two patients with a small acoustic neuroma were treated using this approach. The sizes of the tumors were 11 × 6 mm and 12 × 10 mm. Both tumors were removed completely without residual tumor tissue, and damage to the facial nerve and cochlear nerve was avoided. No patients developed postoperative vertigo, aggravation of postoperative facial paralysis, severe pain, or permanent postoperative complications. The patients were followed up for 6 months, and none developed recurrence. Resection of small acoustic neuromas by the transcanal transvestibular endoscopic approach is a simple and safe technique that achieves excellent functional results.
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Parálisis Facial , Neuroma Acústico , Humanos , Neoplasia Residual , Neuroma Acústico/cirugía , Complicaciones PosoperatoriasRESUMEN
Objective:To compare the difference of upper airway anatomy between non-obstructive sleep apneaï¼OSAï¼ patients and OSA patients, and to analyse the correlation between upper airway anatomy and the disease severity based on the upper airway ultrasound examination. Methods:Eighty-five OSA patients ï¼OSA groupï¼ and 36 non-OSA subjects ï¼non-OSA groupï¼ who were admitted to the Second Hosipital of Shenzhen from January 2021 to May 2021 were recruited to perform upper airway ultrasound measurement. The airway anatomical parameters were compared and analyzed by t-test. The Spearman correlation analysis was performed on the ultrasound measurement values of OSA patients with the apnea-hypopnea index ï¼AHIï¼ and minimum blood oxygen saturation ï¼ LSaOî2ï¼. Results:There were statistically significant differences in BMI, the distance between the soft and hard palate junction and the hyoid bone, the angle between the hard palate and the soft palate, and the angle between the hyoid bone and the hard palate between the OSA group and the non-OSA groupï¼P<0.001ï¼respectivelyï¼; For 85 cases of OSAï¼ correlation analysis between the patient's upper airway B-ultrasound measurements and AHI and LSaOî2 showed that the distance from the soft and hard palate junction to the mandible, the distance from the soft and hard palate junction to the hyoid bone, the thickness of the tongueï¼longitudinal sectionï¼, and the thickness of the soft palateï¼longitudinal sectionï¼are positively correlated with AHIï¼r=0.3758, 0.4619, 0.3227, 0.2738, P<0.05, respectivelyï¼; the distance from the soft and hard palate to the mandible, the distance from the soft and hard palate to the hyoid bone, the width of tongueï¼transverse sectionï¼ï¼and the tongue thicknessï¼longitudinal sectionï¼ are negatively correlated with LSaOî2ï¼r=-0.3566, -0.5470, -0.3168, -0.3098, P<0.05, respectivelyï¼; the angle between the hard palate and the soft palate is negatively correlated with AHIï¼r=-0.2262, P<0.05ï¼; the angle between the hyoid bone and the hard palate is positively correlated with AHI and negatively correlated with LSaOî2ï¼r=0.2889, -0.3351, P<0.01ï¼. Conclusion:The upper airway related anatomical parameters based on ultrasound measurement, such as the distance from the soft and hard palate junction to the mandible, the distance from the soft and hard palate junction to the hyoid bone, the angle between the hyoid bone and the hard palate, and the angle between the hard palate and the soft palate, etc.ï¼ are associated with the disease severity in OSA patients. The correlation may be used as a potential objective indicator to evaluate the severity of patients with OSA.